Form 136 "Adoption Decree" - Vermont

What Is Form 136?

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

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Download Form 136 "Adoption Decree" - Vermont

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Probate Form No. 136
Adoption Decree
STATE OF VERMONT
PROBATE COURT
DISTRICT OF _______________________
IN RE ______________________
DOCKET NO. _____________
ADOPTION DECREE
The court has considered a petition for adoption of the minor, ____________________, filed under
Title 15A V. S. A. (The Adoption Act) and, based upon the evidence submitted at a hearing held on the
_________________ day of ________________________ 20_____, makes the following findings.
1.
The original name of the minor adoptee, or the minor’s original initials are
____________________________________________________________
2.
The said minor was born on the ______ day of _______________, 20_____, at
___________ (A.M./P.M.) In _______________________.
3.
A petition for adoption of the said minor was duly filed by ______________________ on
the __________ day of ________________________ 20_____.
4.
The said petitioner _____ is _____ is not married, and is not a stepparent of the adoptee.
5.
It _____ has _____ has not been duly requested that a new birth certificate be issued by the
Supervisor of Vital Records with the following information therein set forth:
Father :
Name: ______________________________________
Date of Birth: ________________________________
Place of Birth : ________________________________
Mother:
Maiden Name: __________________________________
Name by Which Mother is Known: __________________
Date of Birth: ___________________________________
Place of Birth: __________________________________
6.
The petition requests that the adoptee be known by the name of _____________________
_________________ upon the issuance of this decree.
7.
The adoptee has been in the physical custody of the petitioner for at least 180 days.
8.
Notice of this proceeding for adoption has been served or dispensed with as to those persons
entitled to receive notice under Part 4 of Article 3 of The Adoption Act.
9.
Each necessary consent, relinquishment, waiver, disclaimer of parental interest, judicial
order terminating parental rights, including any order issued under Part 5 of Article 3 of The
Adoption Act, as required by the Adoption act, has been filed with the court.
10.
Any evaluation required by The Adoption Act has ben filed and considered by the court.
11.
Each petitioner is a suitable adoptive parent for the minor.
12.
All applicable requirement of The Adoption Act governing an interstate or intercountry
placement for the adoption have been met.
Probate Form No. 136
Adoption Decree
STATE OF VERMONT
PROBATE COURT
DISTRICT OF _______________________
IN RE ______________________
DOCKET NO. _____________
ADOPTION DECREE
The court has considered a petition for adoption of the minor, ____________________, filed under
Title 15A V. S. A. (The Adoption Act) and, based upon the evidence submitted at a hearing held on the
_________________ day of ________________________ 20_____, makes the following findings.
1.
The original name of the minor adoptee, or the minor’s original initials are
____________________________________________________________
2.
The said minor was born on the ______ day of _______________, 20_____, at
___________ (A.M./P.M.) In _______________________.
3.
A petition for adoption of the said minor was duly filed by ______________________ on
the __________ day of ________________________ 20_____.
4.
The said petitioner _____ is _____ is not married, and is not a stepparent of the adoptee.
5.
It _____ has _____ has not been duly requested that a new birth certificate be issued by the
Supervisor of Vital Records with the following information therein set forth:
Father :
Name: ______________________________________
Date of Birth: ________________________________
Place of Birth : ________________________________
Mother:
Maiden Name: __________________________________
Name by Which Mother is Known: __________________
Date of Birth: ___________________________________
Place of Birth: __________________________________
6.
The petition requests that the adoptee be known by the name of _____________________
_________________ upon the issuance of this decree.
7.
The adoptee has been in the physical custody of the petitioner for at least 180 days.
8.
Notice of this proceeding for adoption has been served or dispensed with as to those persons
entitled to receive notice under Part 4 of Article 3 of The Adoption Act.
9.
Each necessary consent, relinquishment, waiver, disclaimer of parental interest, judicial
order terminating parental rights, including any order issued under Part 5 of Article 3 of The
Adoption Act, as required by the Adoption act, has been filed with the court.
10.
Any evaluation required by The Adoption Act has ben filed and considered by the court.
11.
Each petitioner is a suitable adoptive parent for the minor.
12.
All applicable requirement of The Adoption Act governing an interstate or intercountry
placement for the adoption have been met.
13.
The Indian Child Welfare Act, 25 U. S. C. 1901 et seq., is not applicable to this proceeding;
or, if applicable, its requirements have been met.
14.
The accounting and affidavit required by 3-702 of The Adoption Act has been reviewed by
the court, and the court has denied, modified or ordered reimbursement of any payment or
disbursement that is not authorized under Article 7 of The Adoption Act.
15.
The petitioner has received each report by 2-105 of The Adoption Act.
16.
The court further finds as follows:
Based upon the foregoing, the court finds that it is in the best interest of the said minor to
grant the petition for adoption.
Based upon the foregoing, the court finds that it is in the best interest of the said minor to
Grant the petition for adoption.
Upon this decree becoming final, all parental rights and duties of each former parent of the
adoptee are terminated, and the adoptive parent and the adoptee shall have the legal
relationship parent and child. The effect of this decree shall be as provided in 15A V. S. A.
1-104, 1-105 and 1-106. Any prior order or agreement for visitation or communication with
the minor is now unenforceable.
Any obligation to pay child support in the future will be terminated by the filing of a final
consent to the adoption with the Family Court which ordered the child support and with the
Vermont Office of Child Support (if applicable). Any outstanding child support arrearage
will not be vacated by this decree. A written agreement concerning child support arrearages
may be made by the Obligor and the Obligee and filed with the court which issued the child
support order. In the event that a child support arrearage is owed to the Office of Child
Support Services, the consent of the office must be obtained as part of any agreement to
waive arrearages.
THEREFORE, it is hereby ORDERED AND DECREED that said minor,
______________________________________________, is adopted by and made the child
of ___________________________________________, and shall hereafter bear the name
of _______________________________________.
Dated at _______________________________, Vermont this ______ day of
____________________________________, 20 _____.
_________________________________
Probate Judge
District of _______________________
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