COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. FORM 131A. Plaintiff(s) DOPTION: PETITION ADULT A JUDICIAL SUBPOENA -against- : STATE OF VERMONT DISTRICT OF ____________________, SS. : PROBATE COURT DOCKET NO. _____________ : Defendant(s) IN RE: ADOPTION OF _______________________________________________________ : ...................................................... ADULT ADOPTION PETITION THE PEOPLE OF THE STATE OF NEW YORK 15A V.S.A. § 5-105 Part 1. TO The undersigned petitioners represent that: 1. The person to be adopted is: GREETINGS: Name: ________________________________________________________________________ before WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend Address: ______________________________________________________________________ , the Honorable at the Court Place located at County of of birth: _______________________________ Date of birth: _____________________ Current marital status: __________________________________________________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the If married, please state the place and date of marriage: ______________________________________________________________________________ Full name by which the adoptee is to be known if the petition is granted: ______________________________________________________________________________ liable to Your failure to comply with this subpoena is punishable as a contempt of court and will make you the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 2. of adopting parent(s) is: resultTheyour failure to comply. Name: _______________________________________________________________________ Witness, Honorable , one of the Justices of the Address: ______________________________________________________________________ Court in County, day of , 20 Length of residence at present address: _____________________________________________ Place of birth: ___________________________ Date of birth: ________________________ Current marital status: ___________________________________________________________ (Attorney must sign above and type name below) If married, please state the place and date of marriage: ______________________________________________________________________________ Attorney(s) for Name: _______________________________________________________________________ Address: ______________________________________________________________________ Length of residence at present address: _____________________________________________ Office and P.O. Address Place of birth: ___________________________ Date of birth: ________________________ Current marital status: ___________________________________________________________ Telephone No.: 3. Please state the duration and nature of the relationship between the prospective adoptive parent Facsimile No.: and the adoptee: E-Mail Address: ______________________________________________________________________________ Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Form 131A Plaintiff(s) -against- Part 2. Calendar No. : Page JUDICIAL SUBPOENA 2 : : The prospective adoptive parent and adoptee certify the following: : Defendant(s) 1. The prospective adoptive parent(s) and the adoptee desire to assume the legal relationship of : . .parent .and child. and.to. have .all of .the .rights. and.be .subject. to all of the duties of that relationship. ..... ....... ... . .... .... .. .... ... .. ..... . 2. The adoptee understands that a consequence of the adoption will be to terminate the adoptee's relationship OF THE STATE existing YORK THE PEOPLE as the child of anOF NEW parent, but if the adoptive parent is the adoptee's stepparent, the adoption will not affect the adoptee's relationship with a parent who is the stepparent's spouse, TO will terminate the adoptee's relationship to the adoptee's other parent, except for the right to but inherit from or through that parent. 3. The adoptee and the prospective parent(s) understand the consequences the adoption may have for any right of inheritance, property, or support from adoptive and biological parents. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Part of located at County 3. Persons Interested in Adoption Proceeding in room , on the day of , 20 , at o'clock in the noon, and at any recessed or1. Please state to testify name and last knownwitness inof any other person whose consent to this adjourned date, the full and give evidence as a address this action on the part of the adoption is required: ___________________________________________________________________________ ___________________________________________________________________________ liable to Your failure to comply with this subpoena is punishable as a contempt of court and will make you ___________________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 2. Please state the name, age, and last known address of each biological or adopted child of the prospective adoptive parent(s). If adopted, please state the date and place of adoption: of the Witness, Honorable , one of the Justices ___________________________________________________________________________ Court in County, day of , 20 ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ (Attorney must sign above and type name below) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Attorney(s) for 3. Please state the name, age, and last known address of each living parent or child of the adoptee: ___________________________________________________________________________ Office and P.O. Address ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Part 4. Documents Required Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Form 131A Plaintiff(s) -against- Calendar No. : Page JUDICIAL SUBPOENA 3 : 1. Certified copy of the adoptee's birth certificate and the adoptive parent’s. : 2. Any required consent that has been executed. : Defendant(s) 3. Filing fee of $75.00. : ...................................................... Dated at________________________, Vermont, this_____day of _____________, 200__. THE PEOPLE OF THE STATE OF NEW YORK ______________________________________________, Petitioner(s) TO ______________________________________________ _______________________________________________, Adoptee GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Subscribed , the Honorable and sworn to this ________ day of ______________________, 200__, at the Court before me, located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed ______________________________________________, Notary Public or adjourned date, to testify and give evidence as a witness in this action on the part of the Subscribed and sworn to thiswith this subpoena is punishable as a contempt of court and will make you liable to _____ day of __________________, 200__, Your failure to comply before on the party me,whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ______________________________________________, Notary Public Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) * Consent to the adoption of an adult or emancipated minor is required only of spouse of the prospective adoptive parent. (See attached form.) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com