VERIFICATION I/We verify that we have read and understand the information set forth in the Instructions to the Petition to Register Foreign Adoption Decree. I/We verify 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 understand that false statements made herein are subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date:______________________ _____________________________ Adopting Parent _____________________________ Adopting Parent American LegalNet, Inc. www.FormsWorkflow.com