© 2016 Family Law Self-Help Center Decree of Adoption
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DECA
Name: _________________________
Address: _______________________
City, State, Zip: __________________
Phone: _________________________
Email: _________________________
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Petition of
_
_____________________________ and
_
_____________________________
(adoptive parents’ names)
For adoption of a minor child.
CASE NO.: ____________________
DEPT: ____________________
HEARING DATE: _____________
HEARING TIME: ______________
DECREE OF ADOPTION
This Court, having reviewed the Petition for Adoption filed by the Petitioners, (first
petitioner’s name) _________________________________________________ and (second
petitioner’s name) _________________________________________________, and the matter
coming on regularly to be heard before this Court on the date and time above, and the
Petitioners appearing personally, and it appearing to the satisfaction of the Court that all
required consents to adoption have been filed with this Court and the Court having considered
said documents, and the Court having further examined all documents executed and filed
herein, and finding them in all respects proper, and the Court having ( check one)
waived the requirement for a child welfare services investigation;
reviewed the child welfare services investigation;
and having examined the Petitioners under oath, from which examination the Court finds that
all of the allegations of said Petition are true; if there are two Petitioners, they are married; the
Petitioners have been residents of Clark County for at least six months; the Petitioners are more
than ten years older than the minor child(ren); the Petitioners are financially able to provide for
© 2016 Family Law Self-Help Center Decree of Adoption
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the support and maintenance of the minor child(ren); and it further appearing to the satisfaction
of the Court that the best interests of the child(ren) will be promoted by this adoption; and it
further appearing to the Court that there has been a full compliance with the laws of the State of
Nevada relating to adoptions and a full compliance with N.R.S. 127.220 to 127.310, inclusive.
IT IS THERFORE ORDERED that the Petitioners, (first petitioner’s name)
_________________________________________________ and (second petitioner’s name)
_________________________________________________ are declared the legal and/or
adoptive parents of the following child(ren):
Child’s Current Full Name Date of Birth
IT IS FURTHER ORDERED that if a Petitioner has existing parental rights to the
child(ren), those rights shall remain unaffected.
IT IS FURTHER ORDERED that the minor child(ren)’s names shall be changed as
follows:
Child’s Current Full Name Child’s New Full Name
IT IS FURTHER ORDERED that any other parent named on the child(ren)’s birth
certificates shall be removed, and Petitioners’ names shall appear on the birth certificate as the
only parents to the child(ren).
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IT IS FURTHER ORDERED that the minor child(ren) shall henceforth be regarded
and treated as Petitioner’s natural child and have all the lawful rights as his/her own child,
including the rights of support, protection and inheritance.
DATED this _____ day of _____________________, 20_____.
____________________________________
DISTRICT COURT JUDGE
Respectfully Submitted:
________________________________
(First Petitioner’s signature)
________________________________
(First Petitioner’s printed name)
________________________________
(Second Petitioner’s signature)
________________________________
( Second Petitioner’s printed name)