Adoption Hearing Flag Sheet
This is the Adoption Hearing Flag Sheet of Hawaii. Download
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FAMILY COURTADOPTIONCASE NUMBERFIRST CIRCUITHEARING FLAG SHEETFC-A No.STATE OF HAWAI‘I In the Matter of the Adoption of []ATTORNEY FOR PETITIONER(S)A[]MALE[]FEMALE CHILD,[]PETITIONER(S) PRO SEBorn on:A[]MALE[]FEMALE CHILD,Born on:NameA[]MALE[]FEMALE CHILD,Born on:AddressA[]MALE[]FEMALE CHILD,Born on:City, State, Zip CodebyTelephone Number[]legal spouse of[]civil union partner of[]and[]the child(ren)’s legal parentE-Mail Address[]a married couple[]civil union partners[]an unmarried personPetitioner(s). I.Type of Adoption: (‘x’ all that apply)[]Consent[]Non-Consent[]Step-parent[]Relative:[]Agency:(Relationship to Child)(Name of Agency)II.Consent(s) have been obtained from the following person(s)/agency: (‘x’ all that apply)[]Mother[]Legal Only Father[]Child(ren) 10 years and older[]Natural and Legal Father[]Legal Guardian(s)[]Agency:[]Natural/Adjudicated Father[]Legal Custodian(s)[]Other:II.Consent(s) have not been obtained from the following person(s)/agency: (‘x’ all that apply)[]Mother[]Legal Only Father[]Child(ren) 10 years and older[]Natural and Legal Father[]Legal Guardian(s)[]Agency:[]Natural/Adjudicated Father[]Legal Custodian(s)[]Other:III.Consent(s) of person(s) in paragraph III may be dispensed with and is not required because:In accordance with the Americans with Disabilities Act, as amended, and otherapplicable state and federal laws, if you require accommodation for a disability,please contact the ADA Coordinator at the First Circuit Family Court office bytelephone at 954-8200, fax 954-8308, or [email protected] at least ten(10) working days prior to your hearing or appointment date.Please call the Family Court Service Center, at 954-8290, if you have any questionsabout procedures or how to fill out this form.COURT USE ONLYHo‘okele/FC Adm 1/5/16Page 1 of 2 Pages ADOPTION HEARING FLAG SHEET FAMILY COURTADOPTIONCASE NUMBERFIRST CIRCUITHEARING FLAG SHEETFC-A No.STATE OF HAWAI‘I V.The following exhibits/documents have been filed:[]Certified copy of each child’s birth certificate[]Petitioner’s marriage certificate[]Marriage certificate of adult adoptee[]Death Certificate for child(ren)’s []mother[]father[]Divorce Decree for:(name which Petitioner)[]Order Appointing Legal Custodian or Guardian of the child(ren)[]Paternity Judgment for child(ren)[]Certified copy of the Judgment of Termination of Parental Rights[]Certified copy of the Order Awarding Permanent Custody[]Affidavit of Birth Background[]Foreign Adoption Placement Agency’s Affidavit[]Medical certificate for each child[]Statement of Mailing of Notice to DHS (Department of Human Services) VI.Have any foreign language documents been translated into English?[]Yes[ ]NoVII.The following documents have been given to the Adoption Clerk:[]DOH Medical Information form, Birth Parent’s Consent to Release of Information[]Mother’s medical records of the child(ren)’s birth and Mother’s Consent to Release[]Copy of Adoption Information SheetVIII.List any missing documents, which are required by statute, rule, or official memorandum:IX.Does Interstate Compact on the Placement of Children (ICPC) apply?[]Yes[]NoIf yes, have all the requirement of ICPC been met?[]Yes[]NoX.Does the Indian Child Welfare Act (ICWA) apply to this case?[]Yes[]NoIf yes, have all requirements of ICWA been met?[]Yes[]NoXI.Are you aware of any opposition or objection to the Petition?[]Yes[]NoIf yes, by whom (include relationship to child(ren) and reason(s) for objection, if known)The undersigned Attorney or Petitioner(s) Pro Se hereby certifies that to the best of his or her knowledgeand belief, all of the foregoing are true and correct.DATE SIGNATURE OF ATTORNEY OR PETITIONER PRO SEDATE SIGNATURE OF ATTORNEY OR PETITIONER PRO SEHo‘okele/FC Adm 1/5/16Page 2 of 2 Pages ADOPTION HEARING FLAG SHEETRelevant article from our knowledge database
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