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.
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.
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
Full Name of LEGAL Father
PART II
INFORMATION AFTER ADOPTION (FOR NEW BIRTH CERTIfiCATE)
Full Name of Child After Adoption
FATHER — Full Name
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
Mother’s Legal Name First
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)
Mailing Address of Adoptive Parents
Phone Number
Name and Full Address of Attorney Or Agency Representative
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)
By
ADPH-HS-17/Rev. 10/2009
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