Form 104-Adoption Order

Form 104.

O.20, r.13

ADOPTION ORDER

CHILD ADOPTING PARENTS

Surname Surname

Forenames Other names

(sex) (occupation)

Born . . . , 19.... (address)

at . . . (place) AND

Father's surname Surname

Other names Other names

Mother's maiden surname (occupation)

Other names (address)

THE COURT MAKES AN ORDER for the adoption of the child in favour of the adopting parents and approves the name(s) . . . as the forename(s) of the child.

(Where section 30(2) of the Adoption of Children Act applies add-

THE COURT ORDERS that the child shall have the surname . . . .)

(Complete as in the general form of minute of order under Order 12 Rule 18.)