Kansas Report Of Adoption Form PDF Details

The Kansas Report Of Adoption, denoted as form VS-220 and recently updated in October 2021, holds a crucial position in the legal and administrative landscape of adoption within the state. This comprehensive document not merely facilitates the preparation of an amended birth certificate post-adoption but also serves as a vital record that intertwines with the health and legal sectors by offering a structured way for adoptive parents to update vital statistics records. It meticulously gathers information regarding the child's new name post-adoption, detailed particulars of the adoptive parents such as their names, birthplaces, and social security numbers, and insights into the nature of the adoption, whether it's a step-parent, traditional, or single-parent adoption. Additionally, it addresses whether the adopted child was born in another country and if the adoptive parents are Kansas residents, highlighting its thoroughness in covering varied adoption scenarios. The form further extends to capture attorney details involved in the adoption and demands the authentication by a district court, thereby underscoring the legal rigor involved. Important to note is the form's integration with the Kansas Department of Health and Environment Office of Vital Statistics, which underscores its pivotal role in ensuring that the adoption process complies with state statutes. It articulates the procedure and requirements for adoptive parents, guiding them through the process of formalizing the adoption in Kansas, including stipulations for foreign-born children and the handling of the original birth certificate. This integral document represents a crucial step in legitimizing the familial bond through the legal framework, ensuring that the adopted child's new identity is recognized and properly documented.

QuestionAnswer
Form NameKansas Report Of Adoption Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameskansas adopted report, kansas report of adoption, report adoption, kansas petition for adoption

Form Preview Example

Report of Adoption

FORM VS-220 Revised 10-2021

INFORMATION FOR AMENDED BIRTH RECORD FOLLOWING ADOPTION

 

 

 

 

 

 

 

 

 

 

DO THE PARENTS WISH TO ENROLL THE CHILD IN

CHILD

1. CHILD'S NAME AFTER ADOPTION (First, Middle, Last)

 

 

 

 

 

THE IMMUNIZATION REGISTRY?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

/

 

 

 

 

 

 

 

 

Yes

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. MOTHER'S/PARENT I PRESENT NAME (First, Middle, Last)

 

 

 

2a. SEX

 

2b. LAST NAME PRIOR TO FIRST MARRIAGE

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2C. BIRTH DATE (MM/DD/YYYY)

2d. BIRTH PLACE (State)

 

 

2e. RACE

 

2f. SOCIAL SECURITY NUMBER

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2g. RESIDENCE - At the time of the child's birth: (Street and number, City, County, State, Zip )

 

 

 

Inside City Limits?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. CURRENT MAILING ADDRESS OF PARENT(S): (Street and number, City, County, State, Zip)

 

 

 

Inside City Limits?

PARENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

No

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. FATHER'S/PARENT II NAME (First, Middle, Last)

 

 

 

4a. SEX

 

4b. LAST NAME PRIOR TO FIRST MARRIAGE

FOR NEW

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFICATE

4c. BIRTH DATE (MM/DD/YYYY)

4d. BIRTH PLACE (State)

 

 

4e. RACE

 

4f. SOCIAL SECURITY NUMBER

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Was the child born in a foreign country?

Yes

No

5a. Was the child born to U.S. Citizens?

Yes

No

5b. Did the adoption occur in a foreign country?

Yes

No

5c. Are adopting parent’s Kansas residents?

Yes

No

6. TYPE OF ADOPTION (select one)

 

 

Step-Parent Adoption

 

 

 

Traditional Adoption

 

 

 

Single-Parent Adoption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. NAME OF ATTORNEY:

 

 

 

 

 

7a. EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ATTORNEY

7b. MAILING ADDRESS OF ATTORNEY: (Street and number, City, State, Zip)

7c. TELEPHONE NUMBER + AREA CODE

 

Parent(s) Signature (I/We agree that the above information is true and correct to the best of my/our knowledge)

Parent(s)

Signature

INFORMATION FROM ORIGINAL BIRTH CERTIFICATE

8. CHILD'S NAME AT BIRTH (First, Middle, Last)

 

 

 

 

 

 

/

 

 

/

 

8a. CHILD'S BIRTH DATE (MM/DD/YYYY)

8b. CHILD'S SEX

 

 

8c. BIRTH CERTIFICATE NUMBER (if known)

/

/

 

Male

 

Female

 

9.CHILD'S BIRTH PLACE: (City, County/Province, State/Country)

10.MOTHER'S/PARENT I NAME PRIOR TO FIRST MARRIAGE (First, Middle, Last)

/

/

 

 

11. FATHER'S/PARENT II NAME (First, Middle, Last)

 

/

/

CERTIFICATION OF DISTRICT COURT

(Place court seal here)

I hereby certify that the child identified above was adopted by the above-named parent(s) on the

 

day of

 

,

 

in the District Court of

 

County, KS.

(day)

(month)

(year)

(county)

Case Number

Signature of District Court Judge

Date

Kansas Department of Health and Environment

Office of Vital Statistics

1000 SW Jackson Street, Suite 120, Topeka, Kansas 66612

INSTRUCTIONS

Please enter the information requested for each item. This is a permanent record. All information must be typed.

Kansas District Courts are required by state statute (KSA 59-2104) to report adoptions to the Office of Vital Statistics. If the child being adopted was born outside the state of Kansas, the report of adoption will be forwarded to the appropriate state vital statistics office by the Kansas Office of Vital Statistics.

This Report of Adoption and the original Certificate of Live Birth will be sealed and will be opened only by court order or by written request of the adopted person, if of legal age, as directed by KSA 65-2423.

KSA 65-2423 also authorizes, upon request, the registration of birth certificates in the state of Kansas for children born in foreign countries that are not United States citizens born abroad, but adopted by residents of Kansas or adopted in Kansas.

When a Report of Adoption is received, the Office of Vital Statistics contacts the attorney, or adoptive parents, to obtain one or both parents’ signatures on the supplemental birth certificate. At that time, we also request the filing fee to prepare and file the new birth record.

If this adoption is a step-parent adoption, natural parent information will be taken from the original birth certificate on file with the Office of Vital Statistics.

If any items are unknown, they may be left blank. However, information in items 8 through 10 is needed to locate the original certificate.

You may obtain copies of the new certificate by paying the current certified copy fee.

For information on fees, please visit our website at https://www.kdhe.ks.gov/1171/Amendments-Corrections or call (785) 296-1436.

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2. Soon after filling out the last part, go on to the subsequent part and fill out all required details in all these blanks - ATTORNEY, b MAILING ADDRESS OF ATTORNEY, c TELEPHONE NUMBER AREA CODE, Parents Signature IWe agree that, INFORMATION FROM ORIGINAL BIRTH, CHILDS NAME AT BIRTH First Middle, a CHILDS BIRTH DATE MMDDYYYY, b CHILDS SEX, c BIRTH CERTIFICATE NUMBER if known, Male, Female, CHILDS BIRTH PLACE City, MOTHERSPARENT I NAME PRIOR TO, FATHERSPARENT II NAME First, and CERTIFICATION OF DISTRICT COURT.

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