Interstate Adoption Putative Father Registry Information
In the case of wanting to notify the court of the name and location of a putative father, the following form has to be completed and submitted.
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NHJB-2190-FP (10/31/2006) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) INTERSTATE ADOPTION PUTATIVE FATHER REGISTRY INFORMATION 1. Petitioner name(s) 2. Child’s birthplace (city/town and state) 3. Is there a putative father’s regi stry in the child’s birth state? Yes No 4. If question #3 above is answered yes, please comp lete the following information and attach the appropriate fees or other requirem ents in order for the court to process the search request in the other state: Registry or agency name Mailing address Telephone number 5. If question #3 above is answered no, please list the steps you have taken to determine if a registry exists. Date Petitioner Signature Date Petitioner Signature State of , County of This instrument was acknowledged bef ore me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title
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