Alabama Adoption Report Form PDF Details

In Alabama, there are two types of adoption. The first is an inter-state adoption, which is when a child is adopted by parents who live in a different state than the child. The second type of adoption is a local adoption, which is when a child is adopted by parents who live in the same state as the child. In this blog post, we will be discussing Alabama's inter-state adoption process. More specifically, we will be discussing the report form that must be completed in order to finalize an inter-state adoption. So, if you are thinking about adopting a child from Alabama or if you are already in the process of doing so, then this blog post is for you!

QuestionAnswer
Form NameAlabama Adoption Report Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesalabama report adoptive online, form alabama adoption, hs rev alabama, alabama adoption form

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A L A B A M A

REPORT OF ADOPTI ON

INSTRUCTIONS: Parts I and II of this report must be completed by the petitioners, their attorney, or the Court. If the child was placed by a licensed child-placing agency or the State Department of Human Resources, information about 1) the natural parents, 2) place of birth of the child, and 3) birth certificate number may be omitted. This information is to be furnished to the State Registrar by the agency which placed the child.

Within ten (10) days after the final decree of adoption has been made, the Clerk of the Court shall make his certification in Part III, affix his official seal, and forward this report with the final decree of adoption to the State Registrar, Center for Health Statistics, P. O. Box 5625, Montgomery, Alabama 36103-5625. If the child was born in Alabama a new certificate listing the child’s new name and adoptive parents will be prepared. The fee to prepare this new birth certificate is $25.00 payable to the Alabama State Board of Health. This fee also includes one certified copy of the new certificate. If the adopted child was not born in Alabama, the State Registrar will forward the certified copy of the final decree of adoption and the report of adoption to the proper official in the state of birth. The fee to forward the final decree of adoption and report of adoption to the proper official in the state of birth is $10.00 payable to the Alabama State Board of Health. To obtain a certified copy of this birth certificate, contact the state of birth.

PART I

INFORMATION ABOUT CHILD (To Identify Original Birth Certificate)

 

 

 

 

 

 

NOTE: If the official birth certificate number is entered, the names of the father and mother may be omitted.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of Child at Birth

First

 

 

Middle

 

 

Last

 

Birth Certificate Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth City–Town or Location

 

 

 

 

State and Country of Birth

 

Date of Birth

 

Sex

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Maiden Name of NATURAL Mother

First

 

 

 

Middle

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of LEGAL Father

 

First

 

 

 

Middle

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART II

 

INFORMATION AFTER ADOPTION (FOR NEW BIRTH CERTIfiCATE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full Name of Child After Adoption

 

First

 

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FATHER — Full Name

 

 

First

 

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Father’s State of Birth (If not in U.S.A., name country)

 

 

 

 

 

Father’s Date of Birth

 

 

 

 

Father (Check One)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adoptive

Natural

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTHER — Full Maiden Name

First

 

Middle

 

 

Mother’s Legal Name First

 

 

 

Middle

 

Last

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Date of Birth

 

 

 

Mother’s State of Birth (If not in U.S.A., name country)

 

 

Mother’s Usual Residence—State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Residence — County

 

 

Mother’s Residence — City or Town and Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother’s Residence — Street Address (If rural, give location)

 

 

 

Mother’s Residence — Inside City

Mother (Check One)

 

 

 

 

 

 

 

 

 

 

Limits (Specify Yes or No)

Adoptive

Natural

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address of Adoptive Parents

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and Full Address of Attorney Or Agency Representative

 

 

Phone Number

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART III

 

 

 

CERTIFICATION OF CLERK OF COURT

 

 

 

 

 

 

 

 

 

 

Must be properly signed, dated and sealed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For City, County

 

 

 

 

 

 

 

 

 

Name of Court

 

 

 

 

 

 

 

 

 

of

 

 

 

 

 

 

 

 

 

 

I hereby certify that the adoption as set forth above was made final in this Court by decree dated

and bearing No.

.

 

 

 

 

 

Signature

 

 

(Seal)

Title

 

 

 

By

 

ADPH-HS-17/Rev. 10/2009

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