JV-126 (Rev. 04/16/2014)
PETITION FOR INSPECTION
OF RECORDS OF ADOPTION
G.L. c. 210, § 5C
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
NAME AND ADDRESS OF PETITIONER
DIVISION
NAME OF ADOPTED PERSON
TO BE COMPLETED BY PETITIONER
To the Justices of the Juvenile Court:
I, , respectfully represent that there is good cause for me to
inspect the records of the adoption of the named adopted person as set forth in the affidavit with this petition.
WHEREFORE, I request to inspect the records of the said adoption.
Date
Signature of Petitioner
TO BE COMPLETED BY COURT
ORDER
IT IS ORDERED that: the petitioner may inspect and/or copy all papers filed under the docket
number for this case.
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Date
Signature of Justice