700-00131B_C – Petition to Adopt Minor by Stepparent (08/2019) Page 3 of 4
Information Related to Marital Status:
☐ Single/Never Married ☐ Married
☐ In a Civil Union ☐ Single/Divorced
☐ Spouse/Partner Deceased
If married or in a Civil Union, complete the following information:
Date of Marriage/Union: _________________________ Place of Marriage/Union: ___________________
Spouse/Partner’s Date of Birth: ____________________ Spouse/Partner’s Place of Birth: ______________
If married, has spouse been judicially determined to be incompetent:
☐ Yes ☐ No
If Yes, please provide the date of determination: _________________________________________________
If spouse/partner is deceased, please provide the following information:
Date of Death: _____________ Place of Death: _______________ Cause of Death: _______________
Current Residence of Minor Child
☐ The child has resided with the petitioner since ________________________________.
☐ The child is not currently residing with petitioner because:
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Legal Custody of Minor
I/We have legal custody of the minor
:
☐ Yes ☐ No
If yes, describe the circumstances under which you obtained custody of the minor:
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Information about Living Maternal Grandparents
Full Name of Living Maternal Grandmother: _____________________________________________________
Complete Mailing Address: __________________________________________________________________
Town & State of Residence: __________________________________________________________________
Mailing Address (if different): __________________________________________________________________
Phone Number: __________________________________________________________________
Full Name of Living Maternal Grandfather: ______________________________________________________
If contact information for maternal grandfather is different than maternal grandmother, please complete the information below
Complete Mailing Address: __________________________________________________________________
Town & State of Residence: __________________________________________________________________
Mailing Address (if different): __________________________________________________________________
Phone Number: __________________________________________________________________