FAMILY COURT FIRST CIRCUIT STATE OF HAWAI`I
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
LIST OF EXHIBITS [ ] SUPPLEMENTAL
CASE NUMBER FC-A NO.
[ ]ATTORNEY FOR PETITIONER(S) [ ]PETITIONER(S) PRO SE
Name
Address City, State, Zip Code Telephone Number
[ ]the child(ren)'s legal parent [ ]husband and wife [ ]an unmarried person Petitioner(s).
Exhibit Number
Description of Exhibit
1
Date
Signature of Attorney or Petitioner Pro Se
09/18/01
LIST OF EXHIBITS