Form 2F-P-205 "Specific Consent to Adoption of Mother/Father/Other" - Hawaii

What Is Form 2F-P-205?

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

Form Details:

  • Released on November 27, 2019;
  • The latest edition provided by the Hawaii Family Court;
  • 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 fillable version of Form 2F-P-205 by clicking the link below or browse more documents and templates provided by the Hawaii Family Court.

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Download Form 2F-P-205 "Specific Consent to Adoption of Mother/Father/Other" - Hawaii

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Name, Address & Phone Number
(If Attorney filing, type Name, Address & Phone Number)
[
] Petitioner(s), Pro Se
[
] Attorney for Petitioner(s)
IN THE FAMILY COURT OF THE SECOND CIRCUIT
STATE OF HAWAI`I
FC-A NO. ________________
In the Matter of Adoption of
)
A [ ]MALE
[ ]FEMALE
)
SPECIFIC CONSENT TO ADOPTION
Born on:
)
OF [ ] MOTHER [ ] FATHER
A [ ]MALE
[ ]FEMALE
)
[ ] OTHER
Born on:
)
A [ ]MALE
[ ]FEMALE
)
Born on:
)
A [ ]MALE
[ ]FEMALE
)
Born on:
)
)
by
)
)
)
[ ] the legal spouse of [ ] and
)
)
)
[ ] the child(ren)’s legal parent
)
[ ] husband and wife
[ ] civil union partners
)
[ ] an unmarried person
)
)
Petitioner(s)
)
SPECIFIC CONSENT TO ADOPTION
OF [ ] MOTER [ ] FATHER [ ] OTHER
INFORMATION REGARDING THE PROPOSED ADOPTIVE PARENTS:
PETITIONER
PETITIONER
NAME (Full Legal Name)
Relationship to Child(ren)
2F-P-205 (Rev. 11/27/2019)
Name, Address & Phone Number
(If Attorney filing, type Name, Address & Phone Number)
[
] Petitioner(s), Pro Se
[
] Attorney for Petitioner(s)
IN THE FAMILY COURT OF THE SECOND CIRCUIT
STATE OF HAWAI`I
FC-A NO. ________________
In the Matter of Adoption of
)
A [ ]MALE
[ ]FEMALE
)
SPECIFIC CONSENT TO ADOPTION
Born on:
)
OF [ ] MOTHER [ ] FATHER
A [ ]MALE
[ ]FEMALE
)
[ ] OTHER
Born on:
)
A [ ]MALE
[ ]FEMALE
)
Born on:
)
A [ ]MALE
[ ]FEMALE
)
Born on:
)
)
by
)
)
)
[ ] the legal spouse of [ ] and
)
)
)
[ ] the child(ren)’s legal parent
)
[ ] husband and wife
[ ] civil union partners
)
[ ] an unmarried person
)
)
Petitioner(s)
)
SPECIFIC CONSENT TO ADOPTION
OF [ ] MOTER [ ] FATHER [ ] OTHER
INFORMATION REGARDING THE PROPOSED ADOPTIVE PARENTS:
PETITIONER
PETITIONER
NAME (Full Legal Name)
Relationship to Child(ren)
2F-P-205 (Rev. 11/27/2019)
INFORMATION REGARDING THE CHILD(REN)’S PARENTS:
FATHER
MOTHER
Name (Full Legal Name)
Street Address
City, State, Zip Code
Telephone Number
Social Security Number
Date of Birth
Racial Extraction
INFORMATION REGARDING THE CHILD(REN)’S PARENTS:
LEGAL ONLY FATHER
OTHER LEGAL PARENT
Name (Full Legal Name)
Street Address
City, State, Zip Code
Telephone Number
Social Security Number
Date of Birth
Racial Extraction
INFORMATION REGARDING THE CHILD:
Full Legal Name:
_____________________________________________________
Sex:
[ ] MALE
[ ] FEMALE
Date of Birth:
_____________________________________________________
Place of Birth:
_____________________________________________________
INFORMATION REGARDING THE CHILD:
Full Legal Name:
_____________________________________________________
Sex:
[ ] MALE
[ ] FEMALE
Date of Birth:
_____________________________________________________
Place of Birth:
_____________________________________________________
INFORMATION REGARDING THE CHILD:
Full Legal Name:
_____________________________________________________
Sex:
[ ] MALE
[ ] FEMALE
Date of Birth:
_____________________________________________________
Place of Birth:
_____________________________________________________
INFORMATION REGARDING THE CHILD:
Full Legal Name:
_____________________________________________________
Sex:
[ ] MALE
[ ] FEMALE
Date of Birth:
_____________________________________________________
Place of Birth:
_____________________________________________________
The undersigned being first duly sworn on oath, deposes and says that:
1 .
I am the parent of the above-identified child(ren)
2.
I hereby consent to the legal adoption of the said above-identified child(ren) by the
above-named proposed parent(s), with the understanding and intent that when such
adoption is completed by the entry of a decree, the legal name of the child(ren) may
be changed. (Check only one (1) of the following).
[ ]
I understand that after I sign this Consent to Adoption the Court
approves the adoption, all of my parental rights as well as responsibilities for
said child(ren) will continue.
[ ]
I understand that after I sign this Consent to Adoption the Court
approves the adoption, all of my parental rights as well as responsibilities for
said child(ren) will terminated.
I further understand that by signing Consent to Adoption I will give up any
legal right that I may have to provide care, guidance and control for said
child(ren).
I further understand that by signing this Consent to Adoption I will give up any
legal right that I may have to visit with said child(ren).
I declare that no representations have been made by me, by anyone, which
would serve in any way to limit the complete surrender of all my parental
rights intended by this consent or to limit the parental rights to be acquired by
the proposed adoptive parent(s).
3.
I further understand that after this consent has been signed by me, the consent will
be valid and binding, even though I may be under the age of 18 years.
4.
I further understand that after the child(ren) has started to reside with the adoptive
parent(s) reflected on page 1 of this Consent to Adoption or after this consent has
been filed with the Court in an adoption proceeding by the proposed adoptive
parent(s), this consent may not be withdrawn or repudiated without the written order
of a judge who has jurisdiction in adoption proceedings, based upon a written
finding, supported by proof to be submitted by me, that the withdrawal of my consent
would be in the best interest of the child(ren).
5.
No one has forced or coerced me to sign this Consent to Adoption.
6.
No one has made any promises whatsoever to me in return for signing this Consent
to Adoption.
7.
I have not been offered nor have I accepted any reward or money in exchange for
signing this Consent to Adoption.
8.
I waiver further notice of any proceedings regarding the adoption of the child(ren),
however if the adoption fails to be granted, I want to be given notice.
CONFIDENTIALITY PURSUANT TO HRS §578-15
1.
I have been advised of the requirements of Section 578-15 of the Hawaii Revised
Statutes regarding confidentiality of the court’s adoption file.
2.
When my child becomes 18 years old, my child or the adoptive parents can
request, in writing, to see the court’s file regarding this adoption.
3.
If I do not want the Family Court to reveal my identity to my child or the adoptive
parents, I must file an affidavit requesting confidentiality with the Family Court (on
this island that the adoption occurred) within ninety (90) calendar days before my
th
child’s 18
birthday. This affidavit is good for ten (10) years.
4.
After that, I can file an affidavit every ten (10) years or I can file an affidavit to
keep my identity confidential for the rest of my life.
5.
All affidavits must be filed within ninety (90) days prior to the expiration of the
previous affidavit.
6.
After my child reaches 18 years old, I can request to see the court’s adoption file,
too, but my child has the same rights as I do to keep the file confidential.
7.
My decision to keep my information confidential or not applies to me only and
does not apply to the other natural parent.
8.
I can agree to open up the adoption file at any time and my child can too after
turning 18 years old.
9.
It will be my responsibility to keep the Family Court informed of my current
address if I want disclosure to be made.
10.
The Family Court has no responsibility to notify the child, adoptive parent(s) or
the natural parent(s) of any deadlines or expiration dates.
_________________
____________________________________
DATE
SIGNATURE
On this day, before me personally appeared ____________________________, to me known to be person named in
and who executed the foregoing document and acknowledged that said document was read and is understood by
said person and was executed as the free act and deed of said person
State of Hawai`i
Signature:
Printed Name of Notary Public
Commission
County of Maui
Expires:
Date
Notary Public, State of Hawai`i
Date
Americans with Disabilities Act Notice
If you need an accommodation for a disability when participating in a court program, service, or activity, please contact the ADA
Coordinator as soon as possible to allow the court time to provide an accommodation: Call (808) 244-2855 FAX (808) 244-2932
OR Send an e-mail to: adarequest@courts.hawaii.gov. The court will try to provide, but cannot guarantee, your requested
auxiliary aid, service or accommodation.
2F-P-205 (Rev. 11/27/2019)
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