Free STATE OF MINNESOTA - Minnesota

State of Minnesota
County Judicial District: Court File Number: Case Type:

District Court
Adoption ­ Stepparent

In the Matter of the Petition of: , Petitioner/Parent and , Petitioner/Stepparent To Adopt: , (child's current name) , (child's current name) , (child's current name)

PETITION FOR STEPPARENT ADOPTION (Uncontested)

Petitioners, upon their oaths or affirmations, and to the best of their information and belief, represent to the Court the following: PETITIONERS 1. Petitioners' full names are ___________________________________ (stepparent's name). 2. Petitioners' respective dates of birth are and (stepparent's date of birth). 3. Petitioners were married on of
(city), County of (state). (parent's name) and

(parent's date of birth)

(date of marriage) in the City of (county), State

4. Petitioners presently reside at ___________________________________________________ (street address) in the City of (city), State of Minnesota. 5. Petitioners have resided in Minnesota since ____________________ (date began residing in Minnesota), which (check one):

has been for at least one year as required under Minnesota Statutes § 259.22. has not been for at least one year as required under Minnesota Statutes § 259.22, but,
pursuant to that statute, Petitioners ask the Court to reduce the residency requirement to 30 days as requested in the Motion, Affidavit, and Proposed Order included with this Petition for Stepparent Adoption.

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CHILD(REN) TO BE ADOPTED 6. Stepparent following child(ren):
Child's Current Full Name Child's Current Age and Date of Birth (stepparent's name) Child's County and State of Birth

desires to adopt the
Full Name of Child's Birth Father

Full Name of Child's Birth Mother

7. The above named child(ren) owns no real estate, savings or bank accounts, bonds, securities or personal property other than clothing and personal effects of inconsequential market value, except as shown on attached list. 8. Included with this petition is a certified copy of the child's birth certificate. 9. The child(ren) (check one) is or is not an Indian child(ren) and the Indian Child Welfare Act (ICWA) (check one) does or does not apply. If the child to be adopted is an Indian child and the Indian Child Welfare Act applies, you cannot use this packet of forms because of the additional notice and other requirements involved in the adoption of an Indian child. 10. The Stepparent (stepparent's name) of the above named child(ren) obtained physical custody of said child(ren) at the time of Petitioners' marriage on (date of marriage). 11. The child(ren) has/have lived in the Petitioners' home since the date of Petitioners' marriage. CONSENT 12. Each child to be adopted who is age 14 or older, if any, has consented to be adopted by his/her Stepparent (stepparent's name). The written consent is included with this Petition for Stepparent Adoption and was executed before two competent witnesses and acknowledged by the child before a notary public. 13.
(nonpetitioning parent's name), the nonpetitioning parent of the child(ren), has consented to the adoption of the child(ren) by (stepparent's name). The written consent is included with this Petition for Stepparent Adoption and was executed before two competent witnesses and acknowledged by the nonpetitioning parent before a notary public.

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RESULTS OF SEARCH OF FATHERS' ADOPTION REGISTRY 14. Pursuant to Minnesota Statutes § 259.52, the Fathers Adoption Registry has been searched pursuant to a request of the county social services agency and certification that the registry has been searched, and the results of that search, have been filed with the Court. PARTIES TO ADOPTION PROCEEDING 15. Pursuant to Adoption Rule 35.05, subd. 1(k), following are the names and addresses of the parties to this Stepparent Adoption proceeding:
Category Parent Stepparent Child 1 (if age 10 or older) Child 2 (if age 10 or older) Child 3 (if age 10 or older) Child's Guardian Ad Litem (if one is appointed by Court) Child's legal custodian (if different from parent) Child's legal guardian (if different from parent) Name Address (Street, City, State)

ADOPTION HOME STUDY AND POST-PLACEMENT ASSESSMENT 16. Petitioners understand that, pursuant to Minnesota Statutes § 259.41, subd. 1(b), an adoption home study is not required in this stepparent adoption because the adoption is with an individual who is related to the child. 17. Petitioners understand that, pursuant to Minnesota Statutes § 259.53, a post-placement assessment is required, but may be waived, in a stepparent adoption and, in this case (check one):

Petitioner's do not request waiver of the post-placement assessment and ask the
Court to forward this petition to the appropriate agency to conduct the postplacement assessment, including the required background study and fingerprint check.

Petitioners ask the Court to waive the post-placement assessment as requested in
the Motion, Affidavit, and Proposed Order included with this Petition for Stepparent Adoption. Petitioners understand that even if the Court waives the post-placement assessment, the Court cannot waive the required background

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study and fingerprint check which must be conducted on every adult in the home age 18 and older. COMMUNICATION AND CONTACT AGREEMENT 18. Petitioners understand that, pursuant to Minnesota Statutes § 259.58, they may enter into a communication or contact agreement with the nonpetitioning parent. Petitioners (check one):

Do not wish to enter into a communication or contact agreement with the
nonpetitioning parent.

Wish to enter into a communication or contact agreement with the nonpetitioning
parent and such agreement is included with this Petition for Stepparent Adoption. REQUEST FOR ADOPTION 19. Petitioners desire that the relationship of parent and child be established between the abovenamed child(ren) and Stepparent ____________ (stepparent's name). 20. Petitioners freely undertake the obligation fully to support and care for the above-named child(ren) until the child(ren)'s maturity. 21. It is in the best interests of the above-named child(ren) that the child(ren) be adopted by Stepparent ______________ ______________ (stepparent's name). 22. WHEREFORE, Petitioners request that this Court issue a decree of adoption of the abovenamed child(ren) by (stepparent's name), and for a change of the child(ren)'s name(s) as follows: a. From b. From c. From
(child's current name) to (child's desired name). (child's current name) to (child's desired name). (child's current name) to (child's desired name).

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23. Included with this Petition for Stepparent Adoption, or otherwise filed in the Court file, are the following properly executed documents (check all that apply):

Results of Search of Fathers Adoption Registry A certified copy of the birth certificate of each child to be adopted Original consent signed by the non-petitioning parent Original consent signed by each child to be adopted age 14 or older (if any) List of child(ren)'s personal property Motion, Affidavit, and Proposed Order Reducing Residency Requirement Motion, Affidavit, and Proposed Order Waiving Post-Placement Assessment Communication and Contact Agreement and Proposed Order

Dated: Petitioner/Parent (sign only in front of notary public)

Dated: Petitioner/Stepparent (sign only in front of notary public)

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VERIFICATION AND ACKNOWLEDGEMENT State of Minnesota County of ) ) SS )

The above-named Petitioner/Parent, (parent), being first duly sworn on oath states that Petitioner has read the foregoing Petition for Stepparent Adoption subscribed by him/her, that Petitioner knows the contents thereof, and that the same is true to Petitioner's best information and belief.
(parent name)

Petitioner/Parent
(signature) (sign only in front of notary public)

Subscribed and sworn to before me this ___ day of _________________, _____ ________________________________ Notary Public State of Minnesota County of ) ) SS )

The above-named Petitioner/Stepparent, (stepparent), being first duly sworn on oath states that Petitioner has read the foregoing Petition for Stepparent Adoption subscribed by him/her, that Petitioner knows the contents thereof, and that the same is true to Petitioner's best information and belief.
(stepparent name)

Petitioner/Stepparent
(signature) (sign only in front of notary public)

Subscribed and sworn to before me this ___ day of _________________, _____ ________________________________ Notary Public
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