Adoption Records Release Form
Please complete this form to authorize the release of adoption records.
Full Name of Requestor
First Name
Last Name
Date of Birth of Requestor
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Month
-
Day
Year
Date
Relationship to Adoptee
Adoptee's Full Name
First Name
Last Name
Adoptee's Date of Birth
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Month
-
Day
Year
Date
Reason for Requesting Records
Signature of Requestor
Date of Signature
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Month
-
Day
Year
Date
Submit
Should be Empty: