Stepparent Adoption Consent Form

Child’s Information

Full Name of Child

Date of Birth

Place of Birth

Adoptive Stepparent’s Information

Full Name of Stepparent Relationship to Child

Biological Parent’s Information

Full Name of Consenting Biological Parent

Non-Consenting Parent’s Information

Full Name of Other Biological Parent Current Status (e.g., location, contact status)

Consent Declaration

I hereby voluntarily and unequivocally consent to the adoption of the above-named child by the stepparent listed above. I understand that this adoption will terminate all legal rights and responsibilities of the non-consenting biological parent. Additional Notes (if any)

Signature of Biological Parent Date

Signature of Witness Date