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Petition To Register Foreign Adoption Decree Form. This is a Pennsylvania form and can be use in Orphans Court Statewide.
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Tags: Petition To Register Foreign Adoption Decree, Pennsylvania Statewide, Orphans Court
IN THE COURT OF COMMON PLEAS
___________________ COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
(FAMILY COURT DIVISION in Philadelphia County)
IN RE: FOREIGN ADOPTION OF __________________
FILE NO. _____________
PETITION TO REGISTER FOREIGN ADOPTION DECREE
PURSUANT TO 23 Pa. C.S. § 2908
1.
Petitioner(s), the Adopting Parent(s) of the above-named adopted child,
is/are
2.
Petitioner(s)
reside(s)
Pennsylvania, at
in
________________________
County,
(Street Address)
(City, State, Zip)
3.
Has any other court in this Commonwealth or in any other state reviewed,
registered, finalized or otherwise assumed jurisdiction over the foreign
adoption decree being registered here:
(circle one)
Yes
No
If yes, please provide the name of the court, the state and county, what
was previously presented to the court and the resulting decision from the
court: (Attach all court decrees).
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4.
The full name of the adopted child at birth as listed on the foreign birth
certificate, if available, was
____.
5.
The full name of the adopted child as written on the foreign adoption
decree is
6.
The full name of the adopted child as he or she is to be known from this
time forward is
7.
The date of birth of the adopted child is
.
8.
The date of the foreign adoption decree is
.
9.
The type of United States visa issued to the adopted child is:
(circle one)
10.
IR-2,
IR-3,
IH-3,
IR-4,
IH-4
The following documents are attached to this Petition:
a.
Copy of child’s birth certificate or other birth identification
issued by country of birth; if none, an affidavit of parent(s)
stating why none is available.
b.
Copy of Decree of Adoption issued by foreign government; if
Decree is not in English, an English translation certified by
the translator to be correct.
c.
Copy of adopted child’s United States visa.
d.
Pennsylvania Department of Health, Division of Vital
Records Form No. HD01273F, Certificate of Adoption of a
Foreign-Born Child with Parts 1 and 2 (and Part 3, if
applicable) completed.
e.
Pennsylvania Department of Health, Division of Vital
Records Form No. HD01275F, Statement of Citizenship and
Residency.
f.
Copy of U.S. Government Form N-560, Certificate of
Citizenship, and/or a copy of the child’s United States
passport, if either or both documents are available.
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WHEREFORE, Petitioner(s) request(s) that this Court enter a Decree
authorizing the registration and docketing of the attached Foreign Adoption
Decree with the Clerk of the appropriate Court and decreeing that
___________________________________ shall henceforth be known as
(Name of child as written on Foreign Adoption Decree)
______________________________________________ and shall have all the
(Child’s name from this time forward)
rights of a child and heir of the Petitioner(s).
Signature of Adopting Parent1
Signature of Adopting Parent
_____________________________
Daytime telephone no. for Adopting Parent(s)
1
When there are two adopting parents, both must sign.
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VERIFICATION TO PETITION TO REGISTER FOREIGN ADOPTION DECREE
PURSUANT TO 23 Pa. C.S. § 2908
I/We, ______________, verify that I/we am/are the Petitioner(s) named in the
foregoing Petition, that I/we have read and understand the information set forth in
the Instructions to the Petition to Register Foreign Adoption Decree, and that the
facts set forth in the foregoing Petition are true and correct to the best of my/our
knowledge, information and belief. I/We further verify that all documents
attached to this Petition are true and correct copies of the originals. I/We
understand that false statements made herein are subject to the penalties of 18
Pa. C.S. § 4904 relating to unsworn falsification to authorities.
Date: ____________________
Signature of Adopting Parent
Signature of Adopting Parent
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