State of Alabama
Unified Judicial System
Page 1 of 3
Form PR-1 8/08
PETITION FOR ADULT ADOPTION
(Section 26-10A-16, Ala.Code 1975)
Probate Court
Case No.:
STATE OF ALABAMA
___________________COUNTY
In the Matter of the Adoption Petition of [Full Name(s) and Age(s) of Petitioner(s) and his/her/their residence address(es),
including city(ies) or town(s), state(s), and zip code(s)]
:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
To Adopt _____________________________________________________________ (Name of Person),
an adult.
TO THE HONORABLE _____________________________________, JUDGE OF PROBATE OF
_______________________________ COUNTY, ALABAMA:
Comes now the above-named Petitioner(s), wishing to adopt the person named above pursuant
to the laws of the State of Alabama, who allege(s) the following (Check which boxes are applicable):
[ ] 1. The Petitioner(s) ] is/are residents of, or [ ] is/are in military service in, or [ as an
agency or institution having guardianship or custody of the person to be adopted, has/have an
office in, ___________________________________ the State of Alabama and the county(ies) of
______________________________________.
[ ] 2. The Petitioners are married which marriage occurred on ______________________(date),
in ________________________________________(city or town and state).
[ ] 3. The Petitioner(s) respectfully petition(s) this Court for leave to adopt the above-named
person, whose birth name is ______________________________________, with more detailed
information set out below
(Check which boxes are applicable):
[ ] Other Name(s) By Which the Person Has Been Known: _____________________________
_______________________________________________________________________________
_______________________________________________________________________________.
[ ] Proposed New Name of Person: _______________________________________________.
[ ] City or Town, County, and State in Which the Person Now Resides or Has a Legal
Residence:_____________________________________________________________________.
[ ] Date and City or Town, County, and State of Birth of Person:
_______________________________________________________________________________.
[ ] Name(s) of Birth Parent(s): _____________________________________________________.
[ ] Name of investigating party/agency for unrelated petitioner(s): _______________________
____________________________________________________________________________.
[ ] Name and address of person/agency doing home study: ____________________________
____________________________________________________________________________.
The reason(s) why the person is being adopted (Check which boxes are applicable):
This person can be adopted because:
[ ] the person is an adult stepchild by marriage;
[ ] the person is an adult who consents in writing to be adopted and is related to any
degree of kinship as defined by the intestacy laws of Alabama;
[ ] the person is an adult who is totally and permanently disabled;
[ ] the person is an adult who has been determined to be mentally retarded;
[ ] the person is an adult who consents in writing to be adopted by an adult man and
woman who are husband and wife.
[ 4. The person’s name after the adoption shall be as follows:
_______________________________________________________________________________.
[ 5. The Petitioner(s) wish(es) to establish a parent-child relationship with the person
being adopted, and the Petitioner(s) represent(s) to the Court that he/she/they is/are (a) fit and
proper person(s) able to care for and provide for the adopted person’s welfare.
[ 6. The above-named person being adopted is related to the Petitioner(s) as follows:
______________________________________________________________________________.
[ 7. The Petitioner(s) aver(s) that the above-named person being adopted is now in the
custody of
(If applicable, name(s) and home address(es), including city(ies) or town(s), state(s), and zip
code(s), of any person(s), or address(es) of any agency(ies), etc. who or which currently have custody of the
above-named person to be adopted):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
Name, County, and State of Court Issuing Custody Order and Date of Order:
______________________________________________________________________________.
[ 8. The Petitioner(s) further aver(s) that there exist(s) the following additional order(s) of
court regarding custody or visitation with, or access to, the Adoptee
[Name(s), County(ies), and
State(s) of Court(s) Issuing Custody, Visitation, or Access Order(s) and Date(s) of Order(s)]:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________.
[ 9. If applicable, the name(s) and business address(es) [including city(ies) or town(s),
state(s), and zip code(s)] of the placing agency(ies) is/are as follows:
______________________________________________________________________________
______________________________________________________________________________.
State of Alabama PETITION FOR ADULTADOPTION Probate Court
Unified Judicial System (Section 26-10A-16, Ala.Code 1975) Case No.:
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Form PR-1 8/08
[ ] 10. The name(s), relationship(s), age(s), and home address(es) of a/the person(s)
known to the Petitioner(s) at the time of the filing of this Petition from whom (a) consent(s) or
relinquishment(s) to this adoption are required by law are as follows:
Name/Relationship Age Home Address
___________________ _____ _____________________________________________
___________________ _____ _____________________________________________
___________________ _____ _____________________________________________
___________________ _____ _____________________________________________
[ ] 11. The person who is being adopted has been in the home of the Petitioner(s) since
(date): _______________________________________________________________________.
Attached to this Petition is a copy of the birth certificate of the person who is being adopted
or a copy of an affidavit stating that an application for a birth certificate has been
made.
The premises considered, the Petitioner(s) pray(s) that this Court will do the following,
if applicable: (1) take jurisdiction of the matters contained in this Petition for Adoption; (2) if
applicable, issue an interlocutory order delegating custody and/or the responsibility for the
care, maintenance, and support of the persons being adopted; (3) set a time and date for a
dispositional hearing; and (4) make such other and further orders and decrees as may be
necessary to effectuate the legal adoption of the person.
Dated this the _____________day of ___________________________, 20___.
_________________________________
Signature of Petitioner(s)
STATE OF ___________________________
______________________________ COUNTY
I, __________________________________________, a Notary Public in and for the above-
named County and State, hereby certify that _______________________________________
_______________________________________________________________________, whose
name(s) is/are signed to the foregoing Petition and who is/are known to me, who being first
duly sworn on oath, acknowledged before me on this day, that being informed of the
contents of this Petition, executed the same voluntarily on the day the same bears date.
Given under my hand this the ________day of _________________________, 20___.
_____________________________________
Notary Public
(My commission expires: ___________________)
State of Alabama PETITION FOR ADULT ADOPTION Probate Court
Unified Judicial System (Section 26-10A-16, Ala.Code 1975) Case No.:
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Form PR-1 8/08