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Form #1045Certificate of Relinquishment
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Certificate of Relinquishment - Free Legal Form
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Your use of this site constitutes your acceptance of our terms of use and your
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CERTIFICATE
OF RELINQUISHMENT
Â
This certifies that the attached
document, executed on ____________(Date), by
_____________________________ (Name) of _____________________________
__________________________________ (Address), relinquishing custody of
the child named _________________________ (Name), to
_____________________________, an agency authorized to place children for
adoption in a suitable home, was executed in accordance with the laws of
___________________________ (State/Commonwealth); and that the
above-named child was placed for adoption with _____________________
_____________________________ (Name/Names), of _________________________
_____________________________________________ (Address), who
____________ (Has/Have) filed a petition to formally adopt the
above-named child in the Court of _____________________________________________
(Name and Address of Court).
Â
Approval is hereby granted for
completion of the above-referenced adoption.
Â
In witness whereof, I have signed
this instrument in my capacity as the duly authorized representative of
________________________________________ (Agency).
________________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â _____________
Signature and title of agency
official                                                           Date
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site.
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or any other commercial use is prohibited. This includes reposting forms from this
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Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
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site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
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