______________________________________
IN THE CIRCUIT COURT OF THE ________________JUDICIAL CIRCUIT,
IN AND FOR ____________________________COUNTY, FLORIDA
Case No.:____________________________
Division: ____________________________
IN THE MATTER OF THE ADOPTION OF
___________________ ,
{use name to be given to the minor child} Adoptee.
ORDER GRANTING MOTION FOR SEARCH OF
THE PUTATIVE FATHER REGISTRY
Upon consideration of Petitioners Motion for Search of the Putative Father Registry, this Court finds:
1. This is an action for adoption of a minor by the childs stepparent, Petitioner, who is proceeding
pro se.
2. Section 63.054, Florida Statutes, requires that in every adoption, a search of the Putative Father
Registry maintained by the Department of Health, Office of Vital Statistics be conducted. Section
63.0541, Florida Statutes, makes information maintained by the Registry confidential and
exempt, except that it may be disclosed to adoption entities, registrant unmarried biological
fathers, the birth mother, and the court, upon issuance of a court order concerning a petitioner
acting pro se.
NOW, THEREFORE, IT IS ORDERED THAT:
1. The Office of Vital Statistics, Department of Health shall conduct a search of the Putative Father
Registry upon receipt of a completed application and payment of any authorized fee.
2. The State Registrar shall issue a certificate indicating the results of such search which shall be
filed in this proceeding by transmitting the certificate to the clerk of court.
DONE and ORDERED on: ____________________in __________________________, Florida.
Circuit Judge
Florida Supreme Court Approved Family Law Form 12.981(a)(7), Order Granting Motion for Search of Putative
Father Registry(03/15)
__________________________________________
I certify that a copy of the {name of document(s)} _____________________________________________
was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and to any other
persons or entities listed below on {date} ___________________________________________.
By: Clerk of Court, Designee, or Judicial Assistant
Petitioner (or his or her attorney)
Other: ______________________
State Registrar, Office of Vital Statistics
Florida Supreme Court Approved Family Law Form 12.981(a)(7), Order Granting Motion for Search of Putative
Father Registry(03/15)