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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.981(a)(2), STEPPARENT ADOPTION: CONSENT OF ADOPTEE When should this form be used? This form must be completed and signed by the person being adopted, the adoptee, if he or she is over 12 years of age, unless the court, in the best interest of the minor excuses the minor's consent. It must be signed in the presence of a notary public or deputy clerk and two witnesses other than the notary public or deputy clerk. This form should be typed or printed in black ink. After completing this form, you should file the original with the clerk of the circuit court in the county where the Joint Petition for Adoption by Stepparent, O` Florida Supreme Court Approved Family Law Form 12.981(b)(1) is filed and keep a copy for your records. Special notes... Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Disclosure from Nonlawyer, O` Florida Family Law Rules of Procedure Form 12.900 (a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.

Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption: Consent of Adoptee (03/04)

IN THE CIRCUIT COURT OF THE IN AND FOR

JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division:

IN THE MATTER OF THE ADOPTION OF

, Adoptee(s).

CONSENT OF ADOPTEE 1. I, {full legal name} consent to my adoption by {name} child and heir at law. , being over the age of 12, , to be his/her legal

2.

I have been told of my right to choose a person who does not have an employment, professional, or personal relationship with the adoption entity or prospective adoptive parents to be present when this affidavit is executed and to sign it as a witness. The witness I selected is: {full legal name} [ / only one] ( ( ) I consent to my name being legally changed to {specify} ) I do not consent to a name change.

.

3.

.

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this consent and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: Signature of Adoptee
Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: Business Address: Home Address: Driver's License or State ID Card No.:

Signature of Witness Printed Name: Business Address: Home Address: Signature of Witness Printed Name:

Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption: Consent of Adoptee (03/04)

Driver's License or State ID Card No.:

STATE OF FLORIDA COUNTY OF Sworn to or affirmed and signed before me on by .

NOTARY PUBLIC or DEPUTY CLERK [Print, type, or stamp commissioned name of notary or clerk.] Personally known Produced identification Type of identification produced IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ N fill in all blanks] I, {full legal name and trade name of nonlawyer} , , {city} , a nonlawyer, located at {street} {state} , {phone} , helped {name} , who is the adoptee, fill out this form.

Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption: Consent of Adoptee (03/04)