Form AD0204 "Consent to Adoption by Child Age 14 or Older" - Minnesota

What Is Form AD0204?

This is a legal form that was released by the Minnesota District Courts - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2015;
  • The latest edition provided by the Minnesota District Courts;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form AD0204 by clicking the link below or browse more documents and templates provided by the Minnesota District Courts.

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Download Form AD0204 "Consent to Adoption by Child Age 14 or Older" - Minnesota

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State of Minnesota
District Court
Judicial District:
County
Court File Number:
Adoption – Stepparent
Case Type:
In Re the Petition of:
, Petitioner/Parent
and
Consent to Adoption by
, Petitioner/Stepparent
Child Age 14 or Older
To Adopt:
,
(child’s current name)
,
(child’s current name)
,
(child’s current name)
STATE OF MINNESOTA
)
) SS
COUNTY OF
)
I,
[child’s name], being first duly sworn upon
oath, depose and state as follows:
1. I was born on
[date of birth], I am currently
years
of age, and I reside at
[street
address], in the City of
, County of
, State of
.
2. Of my own free will, and in the presence of two competent witnesses, I hereby consent to
[stepparent’s name].
being adopted by the Petitioner
Child’s Signature
Dated:
[Signature of child – sign only in front of notary public
and two witnesses]
Witnesses’ Signatures
Dated:
[Witness – sign only in front of notary public]
Dated:
[Witness – sign only in front of notary public]
On this
day of
,
,
before me personally appeared the person described herein who executed the foregoing consent
and acknowledged that such consent was freely given, and the persons who were present when
such consent was executed.
Notary Public
AD0204
State
ENG
Rev 7/15
www.mncourts.gov/forms
Page 1 of 1
State of Minnesota
District Court
Judicial District:
County
Court File Number:
Adoption – Stepparent
Case Type:
In Re the Petition of:
, Petitioner/Parent
and
Consent to Adoption by
, Petitioner/Stepparent
Child Age 14 or Older
To Adopt:
,
(child’s current name)
,
(child’s current name)
,
(child’s current name)
STATE OF MINNESOTA
)
) SS
COUNTY OF
)
I,
[child’s name], being first duly sworn upon
oath, depose and state as follows:
1. I was born on
[date of birth], I am currently
years
of age, and I reside at
[street
address], in the City of
, County of
, State of
.
2. Of my own free will, and in the presence of two competent witnesses, I hereby consent to
[stepparent’s name].
being adopted by the Petitioner
Child’s Signature
Dated:
[Signature of child – sign only in front of notary public
and two witnesses]
Witnesses’ Signatures
Dated:
[Witness – sign only in front of notary public]
Dated:
[Witness – sign only in front of notary public]
On this
day of
,
,
before me personally appeared the person described herein who executed the foregoing consent
and acknowledged that such consent was freely given, and the persons who were present when
such consent was executed.
Notary Public
AD0204
State
ENG
Rev 7/15
www.mncourts.gov/forms
Page 1 of 1