November 2016 IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: No. FINAL DECREE CONFIRMING CONSENT TO ADOPTION AND NOW, Petition and after hearing had thereon: , 20 upon consideration of the within The Court, being satisfied as to the truth of the facts set forth in the Petition, finds that the Petition should be granted and further finds that , who executed the consent to the adoption of his/her child, has evidenced the intent to relinquish voluntarily his/her parental rights, and the Court hereby confirms the consent and it is ORDERED, ADJUDGED and DECREED that all parental rights of with respect to are terminated forever, and custody of is hereby awarded to [agency, who is hereby authorized to consent to the adoption of the child] or [individual(s)], and the child may be adopted without further consent or notice to the parent(s). BY THE COURT: J. American LegalNet, Inc. www.FormsWorkFlow.com