Fillable 700 00139D Consent Of Minor In Adoption (Vermont Judiciary)

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700 00139D Consent Of Minor In Adoption (Vermont Judiciary)

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700-00139D - Consent of Minor to Adoption (04/2017) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.
In re Adoption of:
CONSENT OF MINOR TO ADOPTION
15A V.S.A. §2-401(c)
I, being a minor 14 years old or older, voluntarily consent to my adoption.
Name of the Person(s) Seeking to Adopt Me: _______________________________________________
Date
At:
Signature of Minor
City, County and State
Printed Name
Signed and confirmed in the presence of the Judge or in the presence of a person directed by the Judge
Date
Signature
Printed Name of Judge or Other Person Authorized by Judge
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700 00139D Consent Of Minor In Adoption (Vermont Judiciary)

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Completed 15 July 2020

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