Application to adopt a step-child



Download 83.55 Kb.
Date13.04.2016
Size83.55 Kb.
#5297

Application to adopt a step-child


Adoption Act 2009 (sections 92, 93)

This form is to be used to make an application to adopt your step-child. If you are applying to adopt more than one step-child, a separate application must be made for each child.

You may apply to adopt a child who is at least 5 years old and has not yet turned 17. An application relating to a step-child who has turned 17 may be accepted if there is enough time to complete the adoption process before the child turns 18 and the grounds for making an adoption order in your favour are likely to exist. It is not possible for an adult to be adopted.

This form must be signed by you, your spouse and each adult member of your household. Adult household members must give written consent to being assessed as part of the assessment of your application.

Payment of an application fee is required at the time of lodgement of this application with Adoption Services. If you are applying to adopt more than one step- child, a separate application must be made for each child and a separate application fee must be paid for each child. Please refer to the Schedule of fees section of the Department’s website for current fees.

If you have any questions about completing this form or payment options, please phone Adoption Services on (07) 3224 7415 or 1800 647 983 (free call within Queensland).

Please attach additional pages if you wish to provide further information.



Please print clearly using BLOCK LETTERS

Please return completed form:

by mail to:

Adoption Services

Department of Communities, Child Safety and Disability Services

GPO Box 806

Brisbane QLD 4001

by courier or in person to:

Adoption Services

Department of Communities, Child Safety and Disability Services

Level 1, 111 George Street

Brisbane QLD 4000

1. Applicant’s Details (the step parent of the child)


Preferred title (for example: Mr, Mrs, Ms, Dr:

Surname:

Given name/s:

Previous names (for example: maiden name, prior married name, name prior to deed poll change):

Date of birth:

Place of birth (town, country):

Gender (Male or female):

Are you an Australian Citizen? (yes or no):

Have you resided in another state? (yes or no):

If yes, please supply details:

State:

Date/length of stay:

Have you resided in another country? (yes or no):

If yes, please supply details:

Country:

Date/length of stay:

Are you of Aboriginal, Torres Strait Islander or South Sea Islander descent? (Yes, Aboriginal or Yes, Torres Strait Islander or Yes, Aboriginal and Torres Strait Islander or Yes, South Sea Islander or No):

If Aboriginal or Torres Strait Islander descent please provide details of your community and/or language (group if known):

Residential address

Number and Street Address:

Suburb:

State:


Postcode:

How long have you lived at this address?:

Postal address (if applicable)

As above (yes or no):

Number and Street Address / PO Box:

Suburb:

State:

Postcode:

Telephone contact numbers (please indicate with an * the preferred contact number)

Home:


Mobile:

Work:


Email address:

2. Details of applicant’s spouse (the parent of the child)


Preferred title (for example: Mr, Mrs, Ms, Dr):

Surname:

Given name/s:

Previous names (for example: maiden name, prior married name, name prior to deed poll change):

Date of birth:

Place of birth (town, country):

Gender (Male or female):

Is your spouse an Australian Citizen? (Yes or no):

Is your spouse of Aboriginal, Torres Strait Islander or South Sea Islander descent? (Yes, Aboriginal or Yes, Torres Strait Islander or Yes, Aboriginal and Torres Strait Islander or Yes, South Sea Islander or No):

If Aboriginal or Torres Strait Islander descent please provide details of your spouse’s community and/or language (group if known):

Telephone contact numbers (please indicate with an * the preferred contact number)

Home:


Mobile:

Work:


Email address:

3. Details of child the applicant proposes to adopt


Surname:

Given name/s:

Other names by which child has been known (for example: changes of registered surname):

Date of birth:

Place of birth (town, country):

Gender (Male or female):

Is your spouse an Australian Citizen? (Yes or no):

Is the child of Aboriginal, Torres Strait Islander or South Sea Islander descent? (Yes, Aboriginal or Yes, Torres Strait Islander or Yes, Aboriginal and Torres Strait Islander or Yes, South Sea Islander or No):

If Aboriginal or Torres Strait Islander descent please provide details of the child’s community and/or language (group if known):

4. Length of Relationship


Is your spouse the parent of the step child you are seeking to adopt? (yes or no):

Are you married? (yes or no):

If yes, please supply:

Date of marriage:

Place of marriage:

Length of marriage (in years and months):

Have you been living together with your spouse and the child you are seeking to adopt for a continuous period of at least 3 years up to the time of this application? (yes or no):

If yes, please supply:

Date you commenced living continuously with your spouse:

Date the child entered this living arrangement:


5. Leave of Family Court


Has the Family Court of Australia made an order granting leave for adoption proceedings to commence? (yes or no):

If yes, please provide a certified copy of the Order:

Reference number of order:

If no, you are not eligible to submit an Application to adopt a step-child at this time. Please contact the Family Court for more information about making an application for leave for adoption proceedings to commence on 1300 352 000 or visit www.family lawcourts.com.au


6. Non-custodial parent details


Parent Surname:

Given name/s:

Is this person the father or mother of the child? (father or mother):

Is the parent deceased? (yes or no):

If yes, please provide a certified copy of the death certificate if possible or details of the date and place of death

If yes, please also provide the name and contact details for other members of the deceased parent’s family.

Parent’s last known address (if known)

Number and Street Address:

Suburb:

State:


Postcode:

How long have you lived at this address?:

Postal address (if known)

Please tick if not applicable

Number and Street Address / PO Box

Suburb


State

Postcode


Telephone contact numbers (if known)

Home:


Mobile:

Work:


Is the non-custodial parent aware of this application? (yes or no):

If no, please provide details:

Is the non-custodial parent of Aboriginal, Torres Strait Islander or South Sea Islander descent? (Yes, Aboriginal or Yes, Torres Strait Islander or Yes, Aboriginal and Torres Strait Islander or Yes, South Sea Islander or No):

If Aboriginal or Torres Strait Islander descent please provide details of the parent’s community and/or language (group if known):


7. Adult household member’s consent


This section of the form is to be completed by any person aged over 18 years who is a member of the applicant’s household

In accordance with section 111 of the Adoption Act 2009, the assessment of a person’s suitability to adopt their step-child will include an assessment of members of the person’s household. Section 121 of the Adoption Act 2009 further requires that in deciding whether a person is suitable to be an adoptive parent of the child the person wishes to adopt, consideration must be given to the personal history of adult members of the household to decide if an adult household member poses an unacceptable risk of harming a child adopted by the step-parent.

Personal history means criminal history, domestic violence and traffic information including all fines, charges, orders and convictions and in some circumstances investigative information irrespective of when this occurred. This may include overseas or interstate history of a person who has resided outside of Queensland for 12 months or longer.

Information for Applicant


Section 93 of the Adoption Act 2009 requires all adult members of your household to sign the application form and to provide their written consent to being assessed, including personal history checks being undertaken. It is recommended that the consent of adult household members be obtained at the time you submit the application to adopt your step-child. The consent of adult household members can be obtained at a later stage if necessary, for example in circumstances where an adult subsequently joins your household. All current household members must sign the application form.

If adult household members refuse to sign the application form and/or give their written consent to being assessed and to personal history checks being undertaken then your application to adopt your step-child will not be able to proceed.


Information for Adult Household Members


The person completing this form is applying to adopt his or her step-child.

In signing this form you are giving written consent to being assessed and to personal history checks about you being undertaken when an assessment of the person’s suitability to be an adoptive parent is undertaken. At the time the application is being assessed, you will be asked to provide documents to prove your identity and supply other information required to undertake checks.

Note: It is an offence under the Adoption Act 2009 for any person to knowingly provide false or misleading information.

Adult household members



1st Adult

Surname:

Given name/s:

Date of birth:

Place of birth:

Do you agree to being assessed and personal history checks being undertaken if the person’s suitability to adopt their step-child is assessed? (yes or no):

Signature of adult household member:

Date:


2nd Adult

Surname:

Given name/s:

Date of birth:

Place of birth:

Do you agree to being assessed and personal history checks being undertaken if the person’s suitability to adopt their step-child is assessed? (yes or no):

Signature of adult household member:

Date:


3rd Adult

Surname:

Given name/s:

Date of birth:

Place of birth:

Do you agree to being assessed and personal history checks being undertaken if the person’s suitability to adopt their step-child is assessed? (yes or no):

Signature of adult household member:

Date:


4th Adult

Surname:

Given name/s:

Date of birth:

Place of birth:

Do you agree to being assessed and personal history checks being undertaken if the person’s suitability to adopt their step-child is assessed? (yes or no):

Signature of adult household member:

Date:

8. Step-parent adoption application checklist


The step-parent adoption application form must be completed and the following documents must accompany this form at time of lodgement. Please indicate those included.

  • certified copy of Order by the Family Court of Australia confirming leave to commence adoption proceedings has been granted (included or not included):

  • certified copy of a document that proves you are a resident in Queensland (for example, rates notice, signed lease agreement, Queensland driver’s license (front and back), vehicle registration or if no other proof, a statutory declaration witnessed by a Justice of the Peace or Commissioner for Declarations) (included or not included):

  • certified copy of two proof of identification documents (for example, driver’s license (front and back), passport, pension card, credit card, Medicare card) (included or not included):

  • certified copy of full birth certificate for applicant and spouse issued by the office of the Registrar-General, Births, Deaths and Marriages (included or not included):

  • the child’s original full birth certificate issued by the office of the Registrar-General, Births, Deaths and Marriages (or equivalent interstate or overseas authority). This certificate will be returned to you after Adoption Services has taken a copy for certification (included or not included):

  • the child’s original change of name certificate issued by the office of the Registrar-General, Births, Deaths and Marriages (or equivalent interstate or overseas authority). This certificate will be returned to you after Adoption Services has taken a copy for certification (included or not included):

  • certified copy of full marriage certificate (if applicable) issued by the office of the Register-General, Births, Deaths and Marriages (please note: a marriage certificate issued by a church or a marriage celebrant is not acceptable) (included or not included):

  • if not married, a statutory declaration stating the length of time you have lived together as a couple and if possible, copies of documents that provide evidence that you have been living as a couple for a period of at least three years (i.e. joint names on a mortgage document or documents that prove you have resided at the same address) (included or not included):

  • certified copy of divorce decree, if applicable, for both applicant and spouse (included or not included):

  • certified copy of Certificate of Citizenship or Australian passport , if applicable, for both and applicant and spouse (included or not included):

  • certified copy of Certificate of Citizenship or Australian passport, if applicable, for each child (included or not included):

  • If applicant, spouse or any of the children have been known by any other names, or there are changes in the spelling of one or more of these names, certified copies of documents providing evidence of other names (included or not included):

  • If the non-custodial birth parent is deceased, a certified copy of the Death Certificate from the Registry of Births, Deaths and Marriages (or equivalent interstate or overseas authority) (included or not included):

Please note: A certified copy is a true copy of an original document that has been certified in writing by a Justice of the Peace or Commissioner for Declarations as being a true copy of an original document that has been sighted. Documents provided must be written in English or accompanied by a certified translation of the original document. A certified translation of a document means a translation of the document into the English language by a translator who certifies their full name, address, accreditation and qualifications.

9. Applicant’s Spouse


I (spouse’s full name)

  • declare that I am aware of the application by my spouse to adopt my child

  • support the application by my spouse to adopt my child

Signature of applicant’s spouse:

Date:

10. Declaration of applicant


I (applicant’s full name)

  • declare that all the information furnished in this application is true and correct to the best of my knowledge

  • understand that it is an offence under the Adoption Act 2009 for any person to knowingly provide false or misleading information

  • acknowledge that, in accordance with section 95 of the Adoption Act 2009, I must immediately inform Adoption Services of any changes or new information that is relevant to my eligibility

  • have attached all required documents

  • have attached the required application fee or completed a payment authorisation form

  • have completed all sections of the form

Signature of applicant:

Date:


Privacy Notice

In accordance with the Adoption Act 2009, the Department of Communities, Child Safety and Disability Services is authorised to collect the information requested on this form to establish whether you are eligible to apply to adopt your step-child and to assess your suitability to be an adoptive parent. The Department of Communities, Child Safety and Disability Services may provide some or all of this information to the Queensland Police Service, or the police service in another jurisdiction, International Social Service, the Registrar, Births, Deaths and Marriages, Queensland Transport and/or relevant tribunal or court or other person as authorised under the Act. All information obtained in the assessment process will be managed in accordance with the Information Privacy Principles described in the Information Privacy Act 2009.



Form 7 Version 4



Download 83.55 Kb.

Share with your friends:




The database is protected by copyright ©essaydocs.org 2022
send message

    Main page