Petition For Domestic Administrative Adoption
Petition For Domestic Administrative Adoption
Petition For Domestic Administrative Adoption
______________________
x-----------------------------------------------------------x
1. That I, (name of male PAP), was born on (date of birth) at (place of birth). My
mother is (name of mother), a (citizenship of mother) citizen at the time she gave birth
to me, and my father is (name of father), a (citizenship of father) citizen at the time of
my birth. Copy of my Certificate of Live Birth issued by the (name of issuing office) is
hereto attached as Annex "A".
2. That I, (name of female PAP), was born on (date of birth) at (place of birth). My
mother is (name of mother), a (citizenship of mother) citizen at the time she gave birth
to me, and my father is (name of father), a (citizenship of father) citizen at the time of
my birth. Copy of my Certificate of Live Birth issued by the (name of issuing office) is
hereto attached as Annex "B".
3. That the child we sought to adopt is (name of the child) born on (date of birth)
at (place of birth). The birth parent/s of the child is/are (name of birthparent/s or
unknown). Copy of child’s Certificate of Live Birth issued by the Philippine Statistics
Office is hereto attached as Annex "C".
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(Include this statement if the case was presented during the matching conference)
4. A (regional/interregional) matching conference was conducted by the
(RACCO/NACC) on (date of matching conference). The (Regional/Child Placement
Committee) has recommended the adoption placement of (name of child) with us.
Certificate of Matching is hereto attached as Annex “D”. The (RACCO/NACC) issued
the Pre-Adoption Placement Authority on (date of PAPA issuance) signed by (name of
signatory), hereto attached as Annex “D-1”.
5. That adoption social worker, (name of social worker), conducted the necessary
supervised trial custody (STC) and submitted reports to the Regional Alternative Child
Care Office (RACCO).
6. That adoption social worker, (name of social worker), prepared the Social
Case Study Report (SCSR) dated (date of SCSR) and approved by (name and position
of signatory, if applicable) of (name of agency). The SCSR is hereto attached as Annex
“E”.
7. That, as may be applicable, the following person/s have given the consent to
the adoption: (please check)
The legitimate and adopted children, ten (10) years of age or over,
_____ of the adopters, if any;
8. That I/we, am/are financially, physically, and morally capable, hence in the
best position to rear and provide for the needs of the child as evidenced by the attached
documents.
9. That I/we possess all the personal qualifications required under the Republic
Act No. 11642 and I/we am/are qualified to adopt.
10. That the following documentary requirements form part of this Petition, hereto
attached as;
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Annex F-5 National Bureau of Investigation or Police Clearance or
Court Clearance
Annex F-6 Medical Evaluation of the PAPs;
Annex F-7 Medical Evaluation of the child;
Annex F-8 Psychological evaluation of the PAPs;
Annex F-9 Written consent/s to the adoption by those stated in #9
Annex F-10 Documents showing financial capacity;
Annex F-11 Child Care plan with a list of three (3) temporary custodians
of the child in order of preference in case of death, absence,
or incapacity of the PAPs;
Annex F-12 Letters attesting to the character and general reputation of
the PAP/s from at least three (3) non-related character
references of one preferably from an employer or supervisor
or with whom the PAP/s have business dealings;
Annex F-13 Recent 5R (127 x 178 millimeter) close-up and whole-body
pictures of the child;
Annex F-14 Recent 5R (127 x 178 millimeter) close-up and whole-body
pictures of the PAP/s.
11. That I/we, am/are shall appear before the (RCPC/NACC) to prove and
strengthen my/our fitness and qualification to adopt on the date to be determined by the
latter.
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That the grant of this Petition shall create a legal status to our existing parent-
child relationship and shall redound to the best interest of the child, as he/she may then
enjoy the benefits of a legally adopted child as sanctioned by the laws.
PRAYER
Other reliefs just and equitable under the circumstances are also prayed for.
_____________________________
Name and Signature of PAP/s
1.
2.
This instrument consists of ____ pages including this page where the notarial
seal is affixed.
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