Consent of Stepparents Spouse (Biological Parent)
The consent of the biological parents is necessary in an adoption case if they are still alive. In order to provide a legal proof of consent, this form has to be completed and filed by those parents.
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700 -00139 – Consent of Custodial Biological Parent to Adoption (Stepparent /Partner Adoption (04/201 7) Page 1 of 2 STATE OF VERMONT SUPERIOR COURT PROBATE DIVISION Unit Docket No. In re Adoption of: CONSENT OF CUSTODIAL BIOLOGICAL PARENT TO ADOPTION (Stepparent or Partner Adoption ) 15A V.S A. §4 -104 I swear or affirm under oath that the facts set forth below are true and I consent to the adoption of the minor child named below. Information about Custodial Biological Parent signing the Consent: My Name: _________________________________________ Date of Birth: _____________________________ Address: __________________________________________ Email Address: ____________________________ City/State/Zip: ___________________________ __________ Daytime Phone: ___________ ___________ _____ Name of Attorney: __________________________________ __________________________________________ Address of Attorney: _________________________________ City/State/Zip: ____________________________ Information about the M inor to be Adopted: Minor’s Name: ___________________ ___________________ Date of Birth: _____________________________ Information about the Attorney Who R epresents the Prospective Adoptive Parents: Name of Attorney: __________________________________ Phone: __________________________________ Address : ____ _____ _________________________________ City/State/Zip: ____________________________ Agreements : I understand and agree that: (Check All That A pply ) ☐ The adoption will not terminate the parental relationship between the minor and me . ☐ The adoption will terminate the parental relationship between the minor and the other parent of the minor . ☐ The adoption will terminate any existing court order for custody (parental rights and responsibilities) , visitation (parent child contact) or co mmunication with the minor . ☐ The adoption does not terminate the following rights and obligations : A. The minor and any descendant of the minor will retain rights of inheritance from and throu gh the parent of the minor who is no t living with th e stepparent ; and B. A court approved agreement for visitation or communication with the minor after the adoption if the court determines that the agreement is in the best interests of the child. Failure to comply with the court ordered agreement is not g rounds for revoking consent or setting aside the adoptio n; and 700 -00139 – Consent of Custodial Biological Parent to Adoption (Stepparent /Partner Adoption (04/201 7) Page 2 of 2 C. The paren t who is no t living with th e stepparen t re mains liabl e fo r arreara ges of child support unless r e l e a s e d f r o m that obli gation by the parent who lives with the c h i l d and by any govern mental agency pro viding f i n a n c i a l assistance to the minor. This consent is not, and cannot be, a waiver of any further notice to me of the proceeding for adoption of the minor by the person seeking to adopt. Voluntary Consent: I state that I have legal and physical custody of this minor. I voluntarily and unequivocally consent to the adoption of this minor child. I swear or affirm that the facts set forth in this consent are true and correct to the best of my knowledge and belief. Date At: Signature City, County and State Printed Name Signed and confirmed in the presence of the Judge or in the presence of a person directed by the Judge Date Signature Printed Name of Judge or Other Person Authorized by Judge
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