SINGLE PARENT CONSENT TO ADOPTION
I, _______________________________, the
______________ (Mother/Father) of
__________________________________, a _______ (Male/Female)
child born on ____________ (Date),
do hereby consent to ___________ (His/Her)
formal adoption by _____________________________ and
___________________________, husband and wife, who currently reside at
__________________________________________ (Address).
In witness whereof, I have duly executed this
instrument at ______________________ _________________________________ (Place of Execution) on __________ (Date).
_____________________________________________
Signature
This document was hereby signed in the presence of
the following:
_______________________________________ _____________________
Signature Date
_______________________________________ _____________________
Signature Date
