Birth Parents Affidavit And Petition To Appoint Confidential Intermediary (Parent And Child)
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Birth Parents Affidavit And Petition To Appoint Confidential Intermediary (Parent And Child) Form. This is a Wyoming form and can be use in Park Local County.
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Tags: Birth Parents Affidavit And Petition To Appoint Confidential Intermediary (Parent And Child), WYCAI-3, Wyoming Local County, Park
WYCAI-3
Page 1 of 1
WYCAI-3
(REV. 5/25/94)
STATE OF WYOMING
COUNTY OF ____________________
IN THE MATTER OF THE ADOPTION OF
________________________________
)
)
)
IN THE DISTRICT COURT
______________ JUDICIAL DISTRICT
)
)
) CASE #____________________
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ORDER APPOINTING CONFIDENTIAL INTERMEDIARY
The court having reviewed the affidavit and petition to appoint a confidential intermediary, pursuant
to W.S. 1-22-203(b),
IT IS HEREBY ORDERED THAT _________________________________________________ be
appointed as the confidential intermediary of this case and pursuant to W.S. 1-22-203(a)(i), the
confidential intermediary shall have the right to inspect all pertinent confidential relinquishment and
adoption records of the court, governmental agencies, adoption agencies and hospitals within the State
of Wyoming. The confidential intermediary shall have the right to inspect all records relevant to this
adoption, including but not limited to birth, marriage, divorce and death records, without further order of
the court.
IT IS ALSO HEREBY ORDERED THAT in respect to hospital records, the confidential
intermediary's interest in access to such hospital records outweighs the privacy interest of persons to
whom such records relate, and, for good cause shown, the notification provisions of Wyoming Statutes
35-2-610(b) should be and are hereby waived.
IT IS ALSO HEREBY ORDERED THAT the above-named confidential intermediary shall,
pursuant to W.S. 1-22-203(d)(i), file with this court any written consent for contact which has been
obtained from any party involved in this case. This filing shall take place prior to any contact between
the parties.
FURTHERMORE, IT IS HEREBY ORDERED THAT the above-named confidential intermediary
shall, pursuant to W.S. 1-22-203(d)(ii), return to the court all relinquishment and adoption records and
all other information obtained.
Photocopying of records is authorized.
BE IT SO ORDERED this ______ day of _____________________________, 20_____.
_________________________________
DISTRICT JUDGE
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http://www.bighorncountywy.gov/form/courtWYCAI-3.htm
3/1/2007
