Free Journal Entry, CC 17:3 - Nebraska


File Size: 10.8 kB
Pages: 1
File Format: PDF
State: Nebraska
Category: Court Forms - State
Author: mluhman
Word Count: 79 Words, 503 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.supremecourt.ne.gov/forms/county/CC-17-3.pdf

Download Journal Entry, CC 17:3 ( 10.8 kB)


Preview Journal Entry, CC 17:3
STATE OF NEBRASKA FORM NO. CC 17:3 3/87 NEW

CASE NUMBER

JOURNAL ENTRY

IN THE MATTER OF THE ADOPTION OF

JOURNAL ENTRY

Upon the application of

, an Indian who has

reached the age of eighteen years, and who is the subject of an adoptive placement, for information regarding his/her parent's tribal affiliation, the court provided the following information:

Tribal affiliation of Mother Tribal affiliation of Father Other

DATE:

SIGNATURE:

(Seal)

Copy to Applicant Original placed in court file