Fill Out a Valid Alabama Adoption Report Template Access Editor Now

Fill Out a Valid Alabama Adoption Report Template

The Alabama Adoption Report form is a crucial document used to finalize the adoption process in Alabama. This form must be completed by the petitioners, their attorney, or the court, and it includes essential information about the child and adoptive parents. Timely submission of this report is required to ensure the issuance of a new birth certificate reflecting the child's new name and adoptive family.

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The Alabama Adoption Report form plays a crucial role in the adoption process, serving as an official document that captures essential information about the child and the adoptive parents. This form consists of three main parts, each designed to gather specific details required by the state. Parts I and II are filled out by the petitioners, their attorney, or the court, while Part III is completed by the Clerk of the Court. In cases where a licensed child-placing agency or the State Department of Human Resources facilitated the child's placement, certain details such as the natural parents' information and the child's place of birth may be omitted. Following the final adoption decree, the Clerk must certify the report and send it to the State Registrar within ten days. For children born in Alabama, a new birth certificate will be issued, reflecting the child's new name and adoptive parents, for a fee of $25. Conversely, if the child was born outside Alabama, the report and decree will be forwarded to the appropriate official in the state of birth for a fee of $10. The form requires comprehensive information, including the child's original and adoptive names, the names of the adoptive parents, and their contact details, ensuring a smooth transition into the new family structure.

Document Sample

A L A B A M A

REPORT OF ADOPTI ON

INSTRUCTIONS: Parts I and II of this report must be completed by the petitioners, their attorney, or the Court. If the child was placed by a licensed child-placing agency or the State Department of Human Resources, information about 1) the natural parents, 2) place of birth of the child, and 3) birth certificate number may be omitted. This information is to be furnished to the State Registrar by the agency which placed the child.

Within ten (10) days after the final decree of adoption has been made, the Clerk of the Court shall make his certification in Part III, affix his official seal, and forward this report with the final decree of adoption to the State Registrar, Center for Health Statistics, P. O. Box 5625, Montgomery, Alabama 36103-5625. If the child was born in Alabama a new certificate listing the child’s new name and adoptive parents will be prepared. The fee to prepare this new birth certificate is $25.00 payable to the Alabama State Board of Health. This fee also includes one certified copy of the new certificate. If the adopted child was not born in Alabama, the State Registrar will forward the certified copy of the final decree of adoption and the report of adoption to the proper official in the state of birth. The fee to forward the final decree of adoption and report of adoption to the proper official in the state of birth is $10.00 payable to the Alabama State Board of Health. To obtain a certified copy of this birth certificate, contact the state of birth.

PART I

INFORMATION ABOUT CHILD (To Identify Original Birth Certificate)

 

 

 

 

 

 

NOTE: If the official birth certificate number is entered, the names of the father and mother may be omitted.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of Child at Birth

First

 

 

Middle

 

 

Last

 

Birth Certificate Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth City–Town or Location

 

 

 

 

State and Country of Birth

 

Date of Birth

 

Sex

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Maiden Name of NATURAL Mother

First

 

 

 

Middle

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of LEGAL Father

 

First

 

 

 

Middle

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART II

 

INFORMATION AFTER ADOPTION (FOR NEW BIRTH CERTIfiCATE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of Child After Adoption

 

First

 

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FATHER — Full Name

 

 

First

 

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Father’s State of Birth (If not in U.S.A., name country)

 

 

 

 

 

Father’s Date of Birth

 

 

 

 

Father (Check One)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adoptive

Natural

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTHER — Full Maiden Name

First

 

Middle

 

 

Mother’s Legal Name First

 

 

 

Middle

 

Last

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Date of Birth

 

 

 

Mother’s State of Birth (If not in U.S.A., name country)

 

 

Mother’s Usual Residence—State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Residence — County

 

 

Mother’s Residence — City or Town and Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Residence — Street Address (If rural, give location)

 

 

 

Mother’s Residence — Inside City

Mother (Check One)

 

 

 

 

 

 

 

 

 

 

Limits (Specify Yes or No)

Adoptive

Natural

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address of Adoptive Parents

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and Full Address of Attorney Or Agency Representative

 

 

Phone Number

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART III

 

 

 

CERTIFICATION OF CLERK OF COURT

 

 

 

 

 

 

 

 

 

 

Must be properly signed, dated and sealed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For City, County

 

 

 

 

 

 

 

 

 

Name of Court

 

 

 

 

 

 

 

 

 

of

 

 

 

 

 

 

 

 

 

 

I hereby certify that the adoption as set forth above was made final in this Court by decree dated

and bearing No.

.

 

 

 

 

 

Signature

 

 

(Seal)

Title

 

 

 

By

 

ADPH-HS-17/Rev. 10/2009

Form Information

Fact Name Details
Governing Law The Alabama Adoption Report form is governed by Alabama Code Title 26, Chapter 10.
Completion Responsibility Parts I and II must be completed by the petitioners, their attorney, or the Court.
Omission of Information If a licensed child-placing agency or the State Department of Human Resources placed the child, certain information may be omitted.
Timeframe for Submission The Clerk of the Court must submit the report within ten days after the final decree of adoption.
Certification Requirement The Clerk must certify Part III, affix the official seal, and send the report to the State Registrar.
New Birth Certificate A new birth certificate will be prepared if the child was born in Alabama.
Fee for New Certificate The fee for preparing a new birth certificate is $25.00, which includes one certified copy.
Forwarding to Other States If the child was not born in Alabama, the report will be forwarded to the appropriate official in the state of birth.
Fee for Forwarding The fee to forward the final decree and report to another state is $10.00.
Contact for Certified Copy To obtain a certified copy of the birth certificate, contact the state where the child was born.
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