Petition for Adoption (Non-Consent)
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FAMILY COURT
FIRST CIRCUIT
STATE OF HAWAI‘I
PETITION FOR ADOPTION
(NON-CONSENT)
CASE NUMBER
FC-A NO.
In the Matter of Adoption of
A [ ]MALE [ ]FEMALE CHILD,
Born on:
A [ ]MALE [ ]FEMALE CHILD,
Born on:
A [ ]MALE [ ]FEMALE CHILD,
Born on:
A [ ]MALE [ ]FEMALE CHILD,
Born on:
by
[ ]the legal spouse of [ ]and
[ ]the child(ren)'s legal parent
[ ]husband and wife
[ ]an unmarried person
Petitioner(s).
[ ]ATTORNEY FOR PETITIONER(S)
[ ]PETITIONER(S) PRO SE
Name
Address
City, State, Zip Code
Telephone Number
ATTACHMENTS:
[ ] SUPPORTING AFFIDAVIT
[ ]
[ ] ORDER FOR SERVICE BY
( )MAIL ( ) PUBLICATION
( )PERSONAL SERVICE WITHOUT THE STATE
[ ] NOTICE OF TIME AND PLACE OF HEARING
[ ] SUMMONS
TO THE PRESIDING JUDGE OF THE ABOVE-ENTITLED COURT:
Comes now Petitioner(s) above-named alleging that:
JURISDICTION/VENUE
(HRS §578-1):
1. The Family Court has jurisdiction and venue to grant this petition for adoption because:
[ ] Petitioner(s) reside(s) or is/are stationed in the military service on the island on which this
petition is being filed.
[ ] The child(ren) being adopted reside(s) or was born on the island on which this petition is
being filed.
[ ] The agency placing the child for adoption is licensed by the Department of Human Services
and has its principal place of business on the island where this petition is being filed.
2. Petitioner(s) is/are:
[ ] An unmarried person
[ ] Married to the legal father or mother of the child(ren) being
adopted (Stepparent)
[ ] Husband and Wife
[ ] Other: Specify relationship:
FOR COURT USE ONLY
08/07/01 PAGE 1 OR 4 PAGES PETITION FOR ADOPTION (NON-CONSENT)
FAMILY COURT
FIRST CIRCUIT
STATE OF HAWAI‘I
PETITION FOR ADOPTION
(NON-CONSENT)
CASE NUMBER
FC-A NO.
3. INFORMATION REGARDING THE PETITIONERS:
PETITIONER
PETITIONER
Relationship to Adoptee
Name (First, Middle, Last)
Birth Name
Street Address
City, State, Zip Code
Home Telephone Number
Work Telephone Number
Social Security Number
Date of Birth
Place of Birth
Number of Prior Marriages
[ ]No [ ]Yes # Prior Marriages
[ ]No [ ]Yes # Prior Marriages
Number of Criminal Convictions
[ ]No [ ]Yes # Convictions
[ ]No [ ]Yes # Convictions
Contact w/Child Protective Services
[ ]No [ ]Yes
[ ]No [ ]Yes
Present Occupation
Monthly Gross Income
Date of Present Marriage
Number of Persons Living in Your
Home
4. INFORMATION REGARDING THE CHILD: †Page 2A attached if more than one child
Date of Birth
Place of Birth
Sex
[ ]Male [ ]Female
Racial Extraction
Placed by Agency
[ ]No [ ]Yes Name of Agency:
Living w/Petitioner(s) Since
Name after Adoption
(First, Middle, Last)
08/07/01 PAGE 2 OF 4 PAGES PETITION FOR ADOPTION (NON-CONSENT)
FAMILY COURT
FIRST CIRCUIT
STATE OF HAWAI‘I
PETITION FOR ADOPTION
(NON-CONSENT)
CASE NUMBER
FC-A NO.
4. INFORMATION REGARDING THE CHILD (continued):
Date of Birth
Place of Birth
Sex
[ ]Male [ ]Female
Racial Extraction
Placed by Agency
[ ]No [ ]Yes Name of Agency:
Living w/Petitioner(s) Since
Name after Adoption
(First, Middle, Last)
INFORMATION REGARDING THE CHILD (continued):
Date of Birth
Place of Birth
Sex
[ ]Male [ ]Female
Racial Extraction
Placed by Agency
[ ]No [ ]Yes Name of Agency:
Living w/Petitioner(s) Since
Name after Adoption
(First, Middle, Last)
INFORMATION REGARDING THE CHILD (continued):
Date of Birth
Place of Birth
Sex
[ ]Male [ ]Female
Racial Extraction
Placed by Agency
[ ]No [ ]Yes Name of Agency:
Living w/Petitioner(s) Since
Name after Adoption
(First, Middle, Last)
08/07/01 PAGE 2A OF 4 PAGES PETITION FOR ADOPTION (NON-CONSENT)
FAMILY COURT
FIRST CIRCUIT
STATE OF HAWAI‘I
PETITION FOR ADOPTION
(NON-CONSENT)
CASE NUMBER
FC-A NO.
5. The Mother of the child(ren):
[ ] has signed a Consent to Adoption.
[ ] is deceased.
[ ] has not consented to the adoption of the child(ren), but her consent is not required or may
be dispensed with pursuant to the grounds reflected in paragraph 7 below.
6. In regards to the Father(s) of the child(ren):
The Natural Father of the child(ren):
[ ] has signed a Consent to Adoption.
[ ] is deceased.
[ ] has not consented to the adoption of the child(ren), but his consent is not required or may
be dispensed with pursuant to the grounds reflected in paragraph 7 below.
The Legal Only Father of the child(ren): [ ]Not Applicable
[ ] has signed a Consent to Adoption.
[ ] is deceased.
[ ] has not consented to the adoption of the child(ren), but his consent is not required or may
be dispensed with pursuant to the grounds reflected in paragraph 7 below.
7. Mother's and/or Father's consent to the adoption is not required or may be dispensed with
because:
[ ] ( )Father ( )Mother has deserted the child(ren) for a period of at least ninety 90) days.
HRS §578-2(c)(1)(A)
[ ] ( )Father ( )Mother has voluntarily surrendered the care and custody of the child(ren) to
another for a period of two (2) years. HRS §578-2(c)(1)(B)
[ ] ( )Father ( )Mother has failed to communicate with the child(ren) for a period of at least one
(1) year when able to do so. HRS §578-2(c)(1)(C)
[ ] ( )Father ( )Mother has failed to provide for the care and support of the child(ren) for a
period of at least one (1) year when able to do so. HRS §578-2(c)(1)(D)
[ ] The natural father, was not married to the mother of the child(ren), and he is not an
adjudicated, presumed or concerned father. HRS §578-2(c)(1)(E)
[ ] ( )Father ( )Mother had his or her parental rights judicially terminated by a court of
competent jurisdiction. HRS §578-2(c)(1)(F)
[ ] ( )Father ( )Mother had his or her parental and custodial rights divested by an award of
permanent custody pursuant to HRS §587-73. HRS §578-2(c)(1)(K)
[ ] Other grounds pursuant to HRS §578(c)(1) and/or (2):
08/07/01 PAGE 3 OF 4 PAGES PETITION FOR ADOPTION (NON-CONSENT)
FAMILY COURT
FIRST CIRCUIT
STATE OF HAWAI‘I
PETITION FOR ADOPTION
(NON-CONSENT)
CASE NUMBER
FC-A NO.
8. The Legal Custodian or Legal Guardian(s) of the child(ren): [ ]Not applicable.
[ ] signed a Consent allowing the child(ren) to be adopted.
[ ] has not consented to the adoption of the child(ren).
9. If parental rights have not been terminated or divested previously, due notice of the foregoing
allegations and of the time and place of hearing of this petition for adoption will be given to the
non-consenting Parent(s), Legal Custodian or Legal Guardian by:
[ ] personal service.
[ ] certified or registered mail.
[ ] publication.
9. Adoption of the child(ren) by the Petitioner(s) will be in the best interest of the child(ren).
WHEREFORE, it is prayed that:
(a) If parental rights have not been terminated or divested previously, notice of the pendency of this
petition for adoption and of the time and place of hearing be given to the non-consenting Parent(s),
Legal Custodian or Legal Guardian in the manner indicated in paragraph 9 above.
(b) Upon a hearing, the child(ren) be decreed to be the legal child(ren) of the Petitioner(s), effective
of as of the date of filing of this petition.
(c) The name(s) of the child(ren) be decreed as set forth in paragraph numbered 4 above.
(d) The Court decree such further relief as will serve the best interest of the child(ren).
Under penalty of perjury, each Petitioner declares that Petitioner has read this Petition for
Adoption and knows and understands the contents hereof, and that the statements made herein
are true of Petitioner's own knowledge and belief.
DATE
SIGNATURE OF PETITIONER
DATE
SIGNATURE OF PETITIONER
08/07/01 PAGE 4 OF 4 PAGES PETITION FOR ADOPTION (NON-CONSENT)Relevant article from our knowledge database To ensure everybody is satisfied with the adoption, there's a 3 month adjustment'' period before the adoption is complete. An adoption is not going to be prevented by how a child has a legal guardian. In the state of Texas, adoptions can happen so long as an individual is over age 18 shows evidence of having the ability to provide for the youngster and meet their very best interests. It can be a complex legal matter, and you may need an experienced attorney to handle your petition for adoption. It is a wonderful way to build a family. It can be a tricky process. Personal adoptions are lawful in the majority of states.
Read more
By considering numerous children, you're more likely to attach with a kid. The kid has to have a valid visa. In a stepparent or relative adoption, he or she remains in the custody of the person who asked to adopt the child (if that person is able to take care of the child). Once he or she comes to live with you, you will have a trial period to make sure your family and the child are a good fit.
If your son or daughter is qualified for post-adoption subsidies, you're the youngster's advocate and as such you must understand that the little one receives what's due to him. In case the kid is over twelve years old, the youngster must also consent. He or she may be related to the person adopting the child either by blood or by marriage.
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