COUNTY OF NORTHAMPTON



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COUNTY OF NORTHAMPTON REGISTER OF WILLS & ORPHANS' COURT NORTHAMPTON COUNTY COURTHOUSE 669 WASHINGTON STREET EASTON. PENNSYLVANIA 18042 DOROTHY L. COLE REGISTER OF WILLS CLERK OF ORPHANS' COURT REGISTRATION OF FOREIGN ADOPTION 610-559-3092 - Register of Wills 610-559-3095 - Orphans' Court Fax 610-559-3735 -Enclosed in this packet: Instructions for filing Petition to Register Foreign Adoption Decree Petition to Register Foreign Adoption Decree Final Decree Statement of Citizenship and Residency Certificate of Adoption Application for new birth certificate -Fill out Petition to Register Foreign Adoption Decree and Final Decree according to Instruction page -In re: Foreign Adoption of Please put child's initials in this section, not their full name -Fill out Statement of Citizenship form, Certificate of Adoption and Application for Birth Certificate. -A copy of your driver's license is also needed. -Our office needs 2 checks. Make one check payable to the Orphans Court in the amount of $45.00 -Make the other check payable to Vital Records (each copy of birth certificate is $10.00) -When your forms are completed, you must come to the courthouse and present your petition before the Motions Court Judge. Motions Court is held from 9:00am-9:30 am in Courtroom 4. When entering the courtroom see the Judge's assistant and tell them you are there to get an order signed. -After you are finished in Motions Court, bring your paperwork to the Orphans' Court for filing. We will review your paperwork and make sure everything is in order. Our office will send away for the new birth certificate. It will take approximately 4-6 weeks for the birth certificate to be sent to you from Vital Records.

INSTRUCTIONS FOR FILING PETITION TO REGISTER FOREIGN ADOPTION DECREE PURSUANT TO 23 Pa.C.S. 2908 When a child is adopted in conformity with the laws of a foreign country, the adopting parent(s) may register the foreign adoption so that the Foreign Adoption Decree is considered to be a full and final decree, enforceable as if entered pursuant to the Pennsylvania Adoption Act, and a Pennsylvania birth certificate can be obtained. Adopting parent(s) seeking to register the Foreign Adoption Decree must: 1. Complete, sign and date the Petition to Register Foreign Adoption Decree and Verification. If a Foreign Adoption Decree shows that there are two adopting parents, both parents must execute the Petition to Register Foreign Adoption Decree. 2. Attach the following documents to the Petition: A certified copy of the Foreign Adoption Decree; A certified copy of the child's birth certificate. If no birth certificate was issued, a certified copy of any other birth identification issued by the country of birth should be attached. If no birth certificate or birth identification can be obtained, an Affidavit stating the reason should be submitted;. A copy of the child's United States visa; An English translation of all documents not in English, certified by the translator to be true and correct; Form H105.091 (Pennsylvania Department of Health, Vital Records, Certificate of Adoption) with Parts I and II (and Part III if applicable) completed; Pennsylvania Department of Health Statement of Citizenship and Residency Form. 3. The Petition to Register with the attachments should be filed with the Clerk of the Orphans' Court Division of the Court of Common Pleas in which the adopting parent(s) reside(s), except for Philadelphia County resident(s), who must file with the Family Court Division. A filing fee will be charged in accordance with the fee schedule of the county court. After the Petition to Register is filed, it will be submitted to the Court for review. If the Petition to Register and accompanying documents establish that the foreign adoption of the child is full and final, the Court will enter a Decree directing the registration of the Foreign Adoption Decree. The Clerk of the appropriate court will then issue a certificate of adoption and transmit form H105.091 and the Statement of Citizenship and Residency Form to the Department of Health, Division of Vital Records. If the Court cannot determine that the foreign adoption is full and final, it will enter a Decree denying the petition. In that case, it will be necessary to proceed under the Adoption Act and any local rules of court to obtain a full and final Pennsylvania adoption decree. Some of the following are reasons why a foreign adoption may not be a full and final adoption eligible for registration: both adopting parents were not present for the adoption hearing in the foreign country; or the sole adopting parent was not present at the adoption hearing in the foreign country; or the foreign court did not enter a final adoption Decree or Order or its equivalent; or the child's United States visa is not the type that would afford the child full United States citizenship.

IN THE SUPREME COURT OF PENNSYLVANIA In Re: Adoption of New Pa. O. C. Rule 15.8 and Forms No. SUPREME COURT RULES DOCKET NO. PER CURIAM: ORDER AND NOW, this 30 th day of August, 2006, upon the recommendation of the Orphans' Court Procedural Rules Committee, this recommendation having been submitted without publication in the interest of justice, pursuant to Pa.R.J.A. 103(a)(3): IT IS ORDERED, pursuant to Article V, Section 10 of the Constitution of Pennsylvania that: (1) Pennsylvania Orphans' Court Rule 15.8 is adopted as follows; and (2) Uniform forms are adopted as follows and attached to Pennsylvania Orphans' Court Rules as an Appendix following the Pennsylvania Orphans' Court Rules. This ORDER shall be processed in accordance with Pa.R.J.A. 103(b), and shall become effective September 5,2006. Note: Material to be added is underlined.

Rule 15. ADOPTIONS Rule 15.8. Foreign Adoption Registration @} Adoptive parent(s) may petition the court of common pleas in the county of residence to register a foreign adoption decree so that it will be given full and final effect in this Commonwealth. The petition shall be in the form approved by the Supreme Court. {Ql If the court of common pleas determines that the foreign adoption decree cannot be registered, the adoptive parent(s) may proceed under the Adoption Act and local rules of court to obtain a full and final decree of adoption. Explanatory Note: Pursuant to 23 Pa.C.S. 2908(b), as amended by Act 96 of 2006, a set of forms consisting of a petition for registration of a foreign adoption decree, decrees approving and denying the petition, and detailed instructions for pro se petitioners, have been created and are set forth in the Appendix to these rules. The petition should be filed with the Clerk of the Orphans' Court Division, exce'pt in Philadelphia County, where it should be filed with the Clerk of the Family Court Division. The Clerk shall make the necessary Department of Health forms available to petitioners. If the foreign adoption is determined not to be a full and final adoption, the adoptive parent(s) may proceed under the Adoption Act and local rules to seek a decree of adoption in this Commonwealth.

IN THE COURT OF COMMON PLEAS NORTHAMPTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: FOREIGN ADOPTION OF File No: PETITION TO REGISTER FOREIGN ADOPTION DECREE PURSUANT TO 23 Pa.C.S. 2908 1. Petitioner(s), the Adopting Parent(s) of the above named adopted child, is/are 2. Petitioner(s) reside(s) in ~ County, Pennsylvania at (Street Address) (City, State, Zip) 3. The full name of the adopted child at birth was ----- 4. The full name by which the adopted child is to be known is 5. The date of birth of the adopted child is 6. The date of the foreign adoption decree is 7. The type of visa issued to the adopted child is 8. The following documents are attached to this Petition: a. Certified copy of child's birth certificate or other birth identification issued by country of birth; ifnone, an Affidavit ofparent(s) stating why none is available.

b. Certified copy of Decree of Adoption issued by foreign government; if Decree is not in English, an English translation certified by the translator to be correct is attached. c. Copy of adopted child's United States visa. d. Pennsylvania Department of Health Form HI 05.091 (Vital Records Form) with Parts I and II (and Part III, if applicable) completed. e. Pennsylvania Department of Health Statement of Citizenship and Residence. WHEREFORE, Petitioner(s) request(s) that this Court enter a Decree authorizing the registration and docketing of the attached Foreign Adoption Decree with the Clerk ofthe Orphans' Court and decreeing that (Birth Name of Adopted Child) shall henceforth be known as (Name of Child after Adoption) and shall have all the rights of a child and heir of the Petitioner(s). (Adopting Parent) (Adopting Parent)

VERIFICATION IIWe verify that we have read and understand the information set forth in the Instructions to the Petition to Register Foreign Adoption Decree. IIWe verify that the facts set forth in the foregoing Petition are true and correct to the best of my/our knowledge, information and belief. IIWe understand that false statements made herein are subject to the penalties of 18 Pa.C.S. 4904 relating to unsworn falsification to authorities. Date: (Adopting Parent) (Adopting Parent)

IN THE COURT OF COMMON PLEAS NORTHAMPTON COUNTY, PENNYSL VANIA ORPHANS' COURT DIVISION In Re: ADOPTION OF File No: -------- FINAL DECREE AND NOW, this day of, 20, it is hereby ORDERED and DECREED that the Petition of ------------------ (Adopting Parenusj) (Adopting Parent(s)) to Register Foreign Adoption Decree is GRANTED and that this Court authorizes the registration and docketing of the Foreign Adoption Decree entered on by (Date of Foreign Decree) (Name of Foreign Court) 1n ((Foreign Country) It is FURTHER ORDERED and DECREED that the above Foreign Adoption Decree shall be enforceable as if this Court had entered the Decree and that henceforth (Birth Name of Adopted Child) (Child's Name After Adoption) shall be known as and shall have all the rights of a child and heir of -------------------------------- (Adopting Parenust) BY THE COURT: J.

DEPMTMENTOF HfALTH... in pursuit of good health (724) 656-3100 STATEMENT OF CITIZENSHIP AND RESIDENCY IIwe, the adoptive parent(s) of ----',by way of (Name after adoption) adoption in a foreign country, which foreign adoption decree is filed with the court clerk in the Pennsylvania county of residence of the adopting parent(s) pursuant to 23 Pa.C.S. 2908, hereby request Vital Records to register a Pennsylvania birth certificate for the above child pursuant to 35 P.S. 450.403. IIwe declare that at the time of filing the foreign adoption decree with the court clerk, at least one of the child's adoptive parents was a citizen of the United States and a resident of the Pennsylvania county in which the foreign adoption decree was filed. I1we understand that a false statement made herein is subject to the penalties of 18 Pa.C.S. 4904 relating to unsworn falsification to authorities. ADOPTIVE MOTI-IER: ADOPTIVE FATHER: Printed Name Printed Name Signature Date Signature Date Only one parent of United States citizenship needs to sign this form. SCR Division of Vital Records P.O. Box 1528 New Castle, PA 16103-1528

H105.102 REV 12103 BIRTH Application for Certified Copy of Birth Record Pennsylvania Department of Health. Division of Vital Records (Records available from 1906 to the present) BIRTH By my signature below, I state I am the person whom I represent myself to be herein, and I affirm the information within this form is complete and accurate and made subject to the penalties of 18 Pa.C.S. 4904 relating to unsworn falsification to authorities. In addition, I acknowledge that misstating my identity or assuming the identity of another person may subject me to misdemeanor or felony criminal penalties for identity theft pursuant to 18 Pa.C.S. 4120 or other sections of the Pennsylvania Crimes Code. Signature of person making request: Signature required on ALL requests. Must be 18 years of age or older to apply. If under 18, eligible requestor must sign above. PRINT or TYPE your name & CURRENT address. Name: Relationship to Person Named on Certificate: -r-r- -----------------------------~~r----------- Address: City: ----"r~--- Zip: ---- Daytime phone number: (. Intended Use of Certified Copy: DTravel (Date needed: ---.,.=",---'4.::-~'J o School oemployment DDriver's License DOther (List reason: ---7'...,."---------"-.c-..::...------------) Number of copies: Date of Birth: ~-=-.,.---~ Sex: D Male D Female Place of Birth: -----:;r--"---,o-----.--:~"".,.---"-,:::=''--------- Hospital: Full Name 'of Fathe : -=:..~--,:.c:...,:r-----!,...:!r------------------------ W IX W X ~ W == ~0.. X o 5 BIRTH: $10.00 each No fee may be required for birth-records of active or inactive members of the Armed Forces and their dependents. Please complete the following: Armed Forces Member's Name: Service Number: Relationship to Armed Forces Member: Rank and Branch of Service: Iffee is required, make check! money order payable to: VITAL RECORDS. Complete this application and mail with legible copy oud to: Division of Vital Records, /01 South Mercer St., PO Box 1528, New Castle, PA 16101. You are welcome to visit one of our public offices in the following cities: New Castle, PA, Room 401, 101 South Mercer St. Philadelphia, PA, Philadelphia State Office Bldg, Erie, PA, 1910 West 26 th St. Harrisburg, PA, Health and Welfare Bldg, Room 129, 7 th and Forster Sts. Room 1009, 1400 West Spring Garden St. Pittsburgh, PA, Pittsburgh State Office Bldg, Room 512, 300 Liberty Ave. Scranton, PA, Scranton State Office Bldg, Room 112, 100 Lackawanna Ave. For ON-LINE ORDERING or additional information, visit our website: www.health.state.pa.us/vitalrecords