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COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 00-55b

[30 Pa.B. 202]

[Continued from previous Web Page]

Rule 14.4.  Annual Report of Guardian of Person of Incapacitated Person.

   The annual report of the guardian of the person of an incompetent or incapacitated person required by 20 PA.C.S.A. § 5521(c) shall be in the following form:

[Caption]

GUARDIAN OF THE PERSON--ANNUAL REPORT
(20 PA.C.S.A. § 5521(c)

1.    Current address of the incapacitated person.

2.    Describe the type of facility where the incapacitated person presently lives and the type of living arrangements:

3.    Do you contemplate a change of placement in the near future? If yes, state where and the reason.

4.    Describe any major medical or mental problems of the incapacitated person:

5.    Describe what social and recreational activities that are enjoyed by the incapacitate person:

6.    What medical and psychological services are provided to the incapacitated person?

7.    Describe any hospitalizations or medical treatment since the date of your appointment as guardian or since the date of your last report:

8.    How often do you visit the incapacitated person?

9.    On the average, how long are your visits?

10.  Who else visits the incapacitated person and how frequently?

11.  Are there any needs that are not being provided for? If yes, state what and why,

12.  Should the guardianship continue, be terminated, or modified? If yes, please specify the reasons for your opinion.

Date: __________________________________
Signature of Guardian

RULE 15--ADOPTIONS

Rule 15.1.  Local Rules.

   The practice and procedure with respect to adoptions shall be as provided by Act of Assembly and to the extent not inconsistent therewith shall conform with the pertinent provisions of these Rules or special order of the Orphans' Court, or, in the absence thereof, with the provisions of Pa.O.C.R. 15.

Rule 15.1.1.  Local Practice and Procedure.

   Practice and procedure with respect to all proceedings under the Adoption Act, 23 Pa.C.S.A § 2101-2910, shall be as provided by this local Rule 15, and, also, in accordance with the provisions of Pa.O.C.R. 15, to the extent the latter is not inconsistent with the provisions of the current Adoption Act, 23 Pa.C.S.A. § 2101-2910 (the ''Adoption Act'').

Rule 15.1.2.  Exhibits.

   Appended to all petitions for voluntary relinquishment, involuntary termination and adoption shall be the following:

   (a)  A birth certificate or certificate of registration of birth of the subject child which contains the child's name, sex, date of birth and parents' names.

   (1)  Whenever a birth certificate has been filed with the Clerk in a companion proceeding, reference to the companion case term and number shall be sufficient.

   (2)  A notice of birth registration is not an acceptable substitute for a certified copy of a birth certificate or a certification of registration of birth.

   (b)  When required by the Court, certified copies of marriage licenses regarding the biological parent or parents of the subject child and the proposed adoptive parents, as proof of the following:

   (1)  The marital status of the biological mother at the birth of the subject child and for one year prior thereto.

   (2)  The marriage of the proposed adoptive parents to each other.

Rule 15.2.1.  Voluntary Relinquishment to Agency.

   (a)  Petition.

   A Petition under Section 2501 of the Adoption Act to relinquish parental rights and duties with respect to a child who has been in the care of an Agency shall be in a form approved by the court, and shall include the following allegations:

   (1)  The name, address, age, racial background and religious affiliation of each petitioner.

   (2)  The information required in subparagraph (1) as to any parent who is not a petitioner, or the reason why such information is unavailable.

   (3)  The martial status of the mother as of the time of the birth of the child and during one year prior thereto, and, if the mother was married, the name of her husband or husbands, and her maiden name.

   (4)  The name, age, date of birth, racial background, sex and religious affiliation of the child.

   (5)  The name and address of the Agency having care of the child.

   (6)  The date when the child was placed with the Agency and the circumstances surrounding the placement.

   (7)  When the child's parents are not married to each other, whether they intend to marry each other.

   (8)  The reason for seeking relinquishment.

   (9)  That each petitioner understands the petition, has considered the alternatives, and has executed the petition voluntarily to promote what the petitioner believes to be in the petitioner's and the child's best interests.

   (10)  Whether either natural parent of the child is entitled to the benefits of the Soldiers' and Sailors' Civil Relief Act of 1940, as amended (50 U.S.C.A. '501, et. seq.).

   (b)  Exhibits.

   The petition shall have attached to it the following exhibits, in addition to those specified in Rule 15.1.2:

   (1)  The joinder of a parent who is not a petitioner, if obtainable.

   (2)  If the other parent is deceased, a certified copy of the death certificate.

   (3)  The joinder of the Agency having care of the child and its consent to accept custody of the child until such time as the child is adopted. The joinder of the Agency shall be executed and acknowledged by an official authorized to do so, and proof of such authority shall be kept on file with the court (see Rule 15.8.1, infra.).

   (4)  A proposed decree in a form approved by the court.

   (c)  Disposition of Petition.

   (1)  The petition shall be filed with the Clerk, who shall place the matter on the next available hearing list, unless otherwise directed by the court.

   (2)  Absent exceptional circumstances, or unless the other parent is deceased, the court will not entertain a petition by one parent where the rights of the other parent have not been previously terminated or cannot be terminated at the hearing.

   (3)  Information concerning any proposed adoption of the child who is the subject of the petition shall be made available to the court at the hearing.

   (d)  Notice and Hearing.

   (1)  If a parent has not relinquished his or her rights and duties in and to the child, or joined in the other parent's petition hereunder, then notice of the hearing, together with a copy of the petition, shall be served upon the non-petitioning/non-joining parent.

   (2)  Unless excused by the court, at or prior to the hearing, each petitioner and each person whose consent or joinder is attached to the petition shall be examined under oath at the hearing.

Rule 15.3.1.  Voluntary Relinquishment to Adult Intending to Adopt Child.

   (a)  Petition.

   A Petition under Section 2502 of the Adoption Act to relinquish parental rights with respect to a child who has been in the exclusive care of an adult or adults who have filed a report of Intention to Adopt shall be in a form approved by the Court, and shall include the allegations required under subparagraphs (1), (2), (3), (4), (7), (8), (9), and (10) of Rule 15.2.1.(a), and

   (1)  The date when the Report of Intention to Adopt was filed.

   (2)  The date when the child was placed with the adult or adults and the circumstances surrounding the placement.

   (b)  Exhibits.

   The petition shall have attached to it the following exhibits, in addition to those specified in Rule 15.1.2:

   (1)  The joinder of a parent who is not a petitioner, if obtainable.

   (2)  If the other parent is deceased, a certified copy of the death certificate.

   (3)  The separate consent of the adult or adults to accept custody of the child.

   (4)  A proposed decree in a form approved by the Court.

   (c)  Disposition of the Petition.

   (1)  The petition shall be filed with the Clerk, who shall place the matter on the next available hearing list, unless otherwise directed by the Court.

   (2)  Absent exceptional circumstances, or unless the other parent is deceased, the Court will not entertain a petition by one parent where the rights of the other parent have not been previously terminated or cannot be terminated at the hearing.

   (3)  Absent exceptional circumstances, a petition for voluntary relinquishment to an adult intending to adopt will not be entertained by the Court unless a petition for adoption under Section 2701 of the Adoption Act with respect to the subject child has also been filed.

   (d)  Notice and Hearing.

   (1)  If a parent has not relinquished his or her right in the child or joined in the petition hereunder, then notice of the hearing on a parent's petition to voluntarily relinquish rights, together with a copy of the petition, shall be served upon such non-petitioning/non-joining parent.

   (2)  Each petitioner and each person whose joinder or consent is attached to the petition shall be examined under oath at the hearing unless excused by the court.

Rule 15.3.2.  Alternative Procedure for Relinquishment.

   (a)  Petition to Confirm Consent.

   A petition under Section 2504(a) of the Adoption Act shall be in a form approved by the court, and shall include the following allegations:

   (1)  The name, address and standing of the petitioner or petitioners, and the date on which the report of intention to adopt and/or the petition for adoption was filed.

   (2)  The name, age, address and current marital status of the natural parent or parents.

   (3)  The name, sex, date of birth and the child proposed to be adopted, and the date on which the child was placed with the proposed adoptive parents.

   (4)  The date on which the petition or petitions for voluntary relinquishment were filed.

   (5)  The date of the execution of the consent or consents to the adoption by the natural parent or parents.

   (6)  That a period of forty (40) days has elapsed since the execution of the consent to the adoption and that the consenting parent has not filed or proceeded with a petition for voluntary relinquishment of parental rights as provided for in Sections 2501 and 2502 of the Adoption Act.

   (7)  Whether either natural parent of the child is entitled to the benefits of the Soldiers and Sailors' Civil Relief Act of 1940, as amended (50 U.S.C.A. § 501, et seq.).

   (b)  Exhibits to Petition to Confirm Consent.

   The petition shall have attached to it the following exhibits, in addition to those specified in Carbon Co. O.C.R. 15.1.2:

   (1)  The original consent of the natural parent in the form prescribed by Section 2711(d)(l) and (2) of the Adoption Act.

   (2)  A proposed decree in a form approved by the court.

   (c)  Petition for Termination of Parental Rights of Non-Consenting Putative Father

   A petition under Section 2504(c) of the Adoption Act shall be in a form approved by the court, and shall include the following allegations:

   (1)  The name, address and standing of the petitioner or petitioners, and the dates on which the report of intention to adopt and/or the petition for adoption was filed.

   (2)  The name, age, address and marital status of the biological parents as of the birth of the child and during one year prior thereto.

   (3)  The name, sex, date of birth of the proposed adoptee and the date on which the child was placed with the proposed adoptive parents.

   (4)  That the biological mother of the adoptee was unmarried at the child's birth.

   (5)  That the putative father has refused to execute a written consent to the adoption of the proposed adoptee and has not filed an acknowledgment of paternity.

   (6)  Whether the putative father is entitled to the benefits of the Soldiers' and Sailors' Civil Relief Act of 1940, as amended (50 U.S.C.A. § 501, et seq.).

   (d)  Exhibits to Petition for Termination of Parental Rights of Non-Consenting Putative Father

   The petition shall have attached to it the following exhibits, in addition to those specified in Carbon Co. O.C.R. 15.1.2:

   (1)  A birth certificate of the proposed adoptee which indicates that no acknowledgment or claim of paternity has been filed.

   (2)  A proposed decree in a form approved by the Court.

   (e)  Disposition of Petitions Under Section 2504.

   (1)  The petition shall be filed with the Clerk, who shall place the matter on the next available hearing list, unless otherwise directed by the court.

   (2)  Absent exceptional circumstances, the Court will not entertain a petition to confirm the consent of only one biological parent, unless the other parent is the petitioner or the spouse of a petitioner in an adoption pending in this court; or the other parent is a putative father who (i) has refused to executive a consent, and has not filed an acknowledgment of paternity, or (ii) is deceased.

   (3)  Absent exceptional circumstances, a petition to confirm consent will not be entertained by the court unless petition for adoption under Section 2701 of the Adoption Act has been filed with this court.

   (f)  Notice and Hearing.

   (1)  Notice of the hearing on the petition to confirm consent, in the form prescribed by Section 2513(b) of the Adoption Act, together with a copy of the petition omitting all references to the proposed adoptive parents, shall be served upon the natural parent or parents whose consent is sought to be confirmed, the other parent, a putative father whose rights are sought to be terminated, and to the parents or guardian of a consenting parent who has not reached 18 years of age.

   (2)  Each petitioner shall be examined under oath at the hearing.

Rule 15.4.1.  Involuntary Termination of Parental Rights.

   (a)  Petition.

   A petition for involuntary termination of parental rights under Sections 2511 and 2512 of the Adoption Act shall be in the form set forth in Carbon Co. O.C.R. 15.4.2.

   (b)  Exhibits.

   The petition shall have attached to it the following exhibits, in addition to those specified in Carbon Co. O.C.R. 15.1.2:

   (1)  The joinder of the agency having care of the child and its consent to accept custody of the child until such time as the child is adopted. The joinder shall satisfy the requirements of Carbon Co. O.C.R. 15.2.1(b)(3).

   (2)  A proposed decree nisi in the form set forth in Carbon Co. O.C.R. 15.4.3.

   (c)  Disposition of Petition.

   (1)  The petition shall be filed with the Clerk and a copy thereof shall be served upon the respondent. This shall be in addition to the notice of hearing required by Rule 15.4. l(e).

   (2)  At the time when the petition is filed with the Clerk, the matter shall be placed on the next available hearing list by the Clerk. However, the matter shall not be heard before the time for filing responsive pleadings has elapsed (O.C. Rule 3.2.2). Notice thereof shall be given as required by Carbon Co. O.C.R. 15.4.1(e).

   (3)  Absent exceptional circumstances, or unless the other parent is deceased, the court will not entertain a petition for involuntary termination of parental rights riled by an agency or an adult intending to adopt where the parental rights of the other parent have not been previously terminated, or cannot be terminated at the hearing.

   (4)  If the court is satisfied that, after reasonable investigation, the identity of a natural parent is unknown, no notice under this Rule will be necessary with respect to such parent.

   (5)  To establish a ''reasonable investigation'' a ''Petition for Leave to Forego Involuntary Termination Proceedings Regarding the Unknown Parent of (name of child)'' shall be presented to the Motions Judge and shall contain the following allegations:

   (i)  the circumstances surrounding the conception of the child including the approximate date and location;

   (ii)  all of the information regarding the unknown parent that is known by the other natural parent or petitioner; and

   (iii)  the efforts made by the identical natural parent or petitioner, by anyone acting on behalf of the identified parent, by petitioning adoptive parents and/or anyone acting on their behalf, to attempt to identify, locate, or contact the unknown natural parent based on the information provided in subsections (i) and (ii) above; or

   (iv)  the reasons why any of the above information cannot be provided.

   (6)  if a natural parent is not the petitioner there shall be attached to the petition as an exhibit:

   (i)  the consent and joinder of the identified natural parent;

   (ii)  a certified copy of the death certificate of the identified natural parent; or

   (iii)  the affidavit of the identified natural parent that the allegations in the petition are true and correct and that the identity and whereabouts of the other natural parent are unknown to the arrant.

   (7)  If the requirements of subparagraph (6) above cannot be satisfied, the petition shall contain an allegation explaining the reasons therefor.

   (d)  Representation for Minors.

   (1)  Counsel.

   When a petition for involuntary termination is being contested by one or both parents, counsel for the petitioners shall file with the petition or present, to the Motions Judge, prior to the scheduled hearing, a motion for the appointment of counsel to represent the minor child or children, together with a proposed order in a form approved by the court.

   (2)  Guardian Ad Litem.

   When the termination of the parental rights of a minor parent is sought, the court, if it finds that the minor parent is not adequately represented, may appoint a guardian ad litem to represent the interests of the minor parent.

   (e)  Notice and Hearing.

   (1)  Notice of the hearing on the petition for involuntary termination of parental rights, in the form and manner prescribed by Section 2513 of the Adoption Act, shall be served upon the following persons:

   (i)  the parent or parents whose rights are sought to be terminated; and

   (ii)  the parent or parents and the guardian ad litem, if any, of a natural parent who is under the age of 18 years.

   (2)  Each petitioner shall be examined under oath at the hearing unless excused by the court.

   (3)  The notice of hearing required in this Rule shall be in addition to the requirement of service of the petition in accordance with Carbon Co. O.C.R. 15.4.1(c)(1).

   (f)  Decrees of Termination of Parental Rights; Form.

   When a petition for involuntary termination of parental rights is uncontested by the respondent, the court, after hearing, shall issue an order setting forth its findings regarding the grounds for involuntary termination of parental rights and either granting or denying the termination. All such decrees of termination of parental rights in uncontested matters shall be final orders.


Rule 15.4.2.  Form of Petitition for Involuntary Termination.

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IMPORTANT NOTICE

PETITION FOR INVOLUNTARY TERMINATION
OF PARENTAL RIGHTS

IN RE:___________________________No. _________________
To:___________________________ ,
the parents of _________________

   A petition has been filed asking the Court to put an end to all rights you have to your child [insert name of child]. A copy of the petition is attached.

   The Court has set a hearing to consider ending your rights to your child. That hearing will be held in Courtroom No. _____ in the Carbon County Courthouse, at Jim Thorpe, Pennsylvania, on _________________ , ______ , at ______ o'clock __ .m.

RIGHTS TO YOUR CHILD(REN)--You are warned that even if you fail to appear at the scheduled hearing, the hearing will go on without you and your rights to your child(ren) may be ended by the Court without your being present, which means that you will lose all rights to custody, visitation, communication with your child(ren). If termination is granted you will receive no notice of future legal proceedings concerning your child(ren).

LEGAL REPRESENTATION--You have a right to be represented at the hearing by a lawyer. You should take this paper to your lawyer at once. If you do not have a lawyer, go to or telephone the office set forth below to find out where you can get legal help.

LEGAL SERVICES OF NORTHEASTERN PENNSYLVANIA, INC.
122 Iron Street
Lehighton, PA 18235
(610) 377-5400

If you have contacted Legal Services and still have not been able to obtain a lawyer, you can still appear at the hearing to request the appointment of a lawyer. If you are indigent, the Court will appoint a lawyer to represent you.

RIGHTS IF YOU ARE INCARCERATED--If you cannot attend the hearing because you are or will be in jail, and want a lawyer, or want to appear at the hearing, you must write within ten (10) days of the receipt of this notice to:

PRESIDENT JUDGE
CARBON COUNTY COURTHOUSE
JIM THORPE, PA 18229

Name of Attorney: __________

Address: __________

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION

IN RE: ADOPTION OF : No. ______
_________________:

PETITION FOR INVOLUNTARY TERMINATION
OF PARENTAL RIGHTS
(Section 2512 of the Adoption Act)

   AND NOW, this ______ day of _________________ , ______ , comes the Petitioner(s), and sets forth the following facts:

Names of Petitioner(s) __________

Describe the relationship of the Petitioner(s) to the child:
 
 
__________

3.  Regarding the child(ren), provide the following information:

Religious
NameAgeDOBRaceSexAffiliation
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________

4.  Regarding the parent(s) who are the subject of the Petition, provide the following:

Religious
NameAgeDOBRaceSexAffiliation

5.  Was the mother married at any time during one year prior to the birth of the child(ren)?

Yes ______            No ______

If yes, provide the name of each husband and mother's maiden name:
 
__________
 
__________

6.  The Petitioner(s) is authorized to seek termination pursuant to Section 2512 of the Adoption Act on the basis that the petitioner(s) is/are (check the applicable status):

____   a parent who seeks termination with respect to the other parent;

____   an agency;

____   an individual having custody or standing in loco parentis to the child, who has filed a report of intention to adopt under Section 2531 of the Adoption Act;

____   an attorney representing a child or a guardian ad litem representing a child who has been adjudicated dependent under 42 Pa.C.S. § 6431(c) (relating to adjudication).

7.  The grounds for termination of parental rights upon which the petitioner(s) rely are: (check applicable grounds)

____   the parent by conduct continuing for a period of at least (6) months immediately preceding the filing of the petition either has evidenced settled purpose of relinquishing parental claim to a child or has refused or failed to perform parental duties;

____   the repeated and continued incapacity, abuse, neglect or refusal of the parent has caused the child to be without essential parental care, control or subsistence necessary for his physical or mental well-being and the conditions and causes of the incapacity, abuse, neglect or refusal cannot or will not be remedied by the parent;

____   the parent is the presumptive but not the natural father of the child;

____   the child is in the custody of an agency, having been found under such circumstances that the identity or whereabouts of the parent is unknown and cannot be ascertained by diligent search and the parent does not claim the child within three months after the child is found;

____   the child has been removed from the care of the parent by the Court or under a voluntary agreement with an agency for a period of at least six months, the conditions which led to the removal or placement of the child continue to exist, the parent cannot or will not remedy those conditions within a reasonable period of time, the services or assistance reasonably available to the parent are not likely to remedy the conditions. Which led to the removal or placement of the child within a reasonable period of time and termination of the parental rights would best serve the needs and welfare of the child;

____   in the case of a newborn child, the parent knows or has reason to know of the child's birth, does not reside with the child, has not married the child's other parent, has failed for a period of four months immediately preceding the filing of the petition to make reasonable efforts to maintain substantial and continuing contact with the child and has failed during the same four month period to provide substantial financial support for the child;

____   the parent is the father of a child who was conceived as a result of a rape;

____   the child has been removed from the care of the parent by the Court or under a voluntary agreement with an agency, twelve (12) months or more have elapsed from the date of removal or placement, the conditions which led to the removal or placement of the child continue to exist and termination of parental rights would best serve the needs and welfare of the child.

8.  The facts which support each of the grounds checked above, and which establish that termination of parental rights would be in the best interests of the child, are set forth as follows (provide a statement of the facts underlying your petition, or a report from Children and Youth Services.)
 __________ 
__________
 
__________
 
__________

9.  If the petitioners) is not an agency, has a Petition for Adoption been filed or is adoption presently contemplated?

                     Yes ____               No ____

Is/are the child(ren) placed in the care of the petitioners?

                     Yes ____               No ____

If yes, give the date of placement: _________________

10.  The petitioner(s) will assume custody of the child(ren) if this petition is granted.

11.  If the father of the child(ren) has not been identified, has a claim of paternity been filed?

                     Yes ____               No ____

12.  Is either parent entitled to benefits under the Soldiers' and Sailors' Civil Relief Act (50 U.S.C.A. § 501, et seq)?

                     Yes ____               No ____

13.  The following exhibits are attached:

               ____ birth certificate(s) of child(ren)

               ____ consent of parent for petitioner under age eighteen (18)

               ____ statement of facts or report from Children and Youth Services

VERIFICATION:

I,         (We) verify that the statements made in this Petition are true and correct. I understand that statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.

WHEREFORE, the Petitioner(s) request(s) that a hearing be scheduled and a rule to show cause issued to the respondent(s) directing them to appear before the Court at a day and time scheduled.

___________________________
Attorney for Petitioner

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION

AFFIDAVIT OF SEARCH
(To be filed if parents' whereabouts are unknown)

IN RE: Adoption of : No. ______
_________________:

   I hereby certify that I have made the following efforts to locate the parent(s):

1.  Searched file for addresses (Children and Youth Services).

2.  Contacted or searched (check those that are applicable):

____      Known relatives and friends

____      Phone Book

____      Post Office

____      Prisons, State and Local

____      Clerk of Courts

____      CHRI

3.  Publication

I verify that the statements herein are true and correct and subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.

___________________________

Rule 15.4.3.  Form of Decree Nisi and Final Decree.

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION

IN RE: Adoption of : No. _________________
: Docket ______ Page ______
___________________________: Filing Fee _________________
(Adoptee's name as on birth certificate) Attorney _________________

DECREE NISI
(Involuntary Termination of Parental Rights)

   AND, NOW, this ______ day of _________________ . ______ , after review of the record and after an evidentiary hearing following due notice, the Court makes the following findings and judicial determinations:

1.  Petitioner(s) has/have established a legal basis for terminating the parental rights of _________________ , hereinafter referred. to as Respondent(s).

2.  The following subsection(s) of 23 Pa.C.S.A Section 2511 establish the basis for terminating the parental rights of Respondent(s).

Check the applicable subsections:

____  a.  The parent(s) by conduct continuing for a period of at least six months immediately preceding the filing of the Petition either has evidenced a settled purpose of relinquishing parental claim to a child or has refused or failed to perform parental duties.

____  b.  The repeated and continued incapacity, abuse, neglect or refusal of the parent(s) has caused the child to be without essential parental care, control or subsistence necessary for his physical or mental well-being, and the conditions and causes of the incapability, abuse, neglect or refusal cannot or will not be remedied by the parent(s).

____  c.  The parent is the presumptive but not the natural father of the child.

____  d.  The child is in the custody of an agency, having been found under such circumstances that the identity or whereabouts of the parent(s) is/are unknown and cannot be ascertained by diligent search, and the parent(s) does/do not claim the child within three months after the child is found.

____  e.  The child has been removed from the care of the parent(s) by the Court or under a voluntary agreement with an agency for a period of at least six (6) months, the conditions which led to the removal or placement of the child continue. to exist, the parent(s) cannot or will not remedy those conditions within a reasonable period of time, the service or assistance reasonably available to the parent(s) are not likely to remedy the condition which led to the removal or placement of the child within a reasonable period of time and termination of the parental rights would best serve the needs and welfare of the child.

____  f.  In the case of a newborn child, the parent knows or has reason to know of the child's birth, does not reside with the child, has not married the child's other parent, has failed for a period of four months immediately preceding the filing of the Petition to make reasonable efforts to maintain substantial -and continuing contact with the child and has failed during the same four-month period to provide substantial financial support for the child.

____  g.  The parent is the father of a child who was conceived as a result of a rape.

3.  The decision of the Court is based on the following findings of fact:
 
__________
 
__________
 
__________

4.  It is hereby Ordered, Adjudged and Decreed that the parental rights of the above-mentioned Respondent(s) to adoptee are forever terminated.

5.  The adoption of ADOPTEE may continue without further notice to or consent of the above-mentioned Respondent(s).

6.  The custody of ADOPTEE is hereby transferred to

a.  the adopting parent(s) __________

b.  an approved Agency and such Agency is hereby authorized to give consent to the adoption of ADOPTEE.

Unless exceptions are filed with the Clerk of the Orphans'Court within ten (10) days after the entry of this decree, the decree will be made final.

BY THE COURT:
___________________________

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION

IN RE: ADOPTION OF : No. ______
_________________:

FINAL DECREE

   AND NOW, this ______ day of ______ , ______ , whereas a Decree Nisi was entered in the within matter, and [no exceptions having been filed] or [exceptions having been filed thereto, and after hearing, the said exceptions are hereby dismissed], it is hereby ORDERED and DECREED that a final decree be entered and that all parental rights and duties of _________________ are terminated forever. The adoption of the said child may be decreed without further consent of or notice to the aforesaid parent.

   In accordance with 23 Pa.C.S.A. § 2905(d), said parent is advised of the continuing right to place and update personal and medical history information, whether or not the medical condition is in existence or discoverable at this time, on file with the Court and with the Department of Welfare.

BY THE COURT:
___________________________

THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION

IN RE: ADOPTION OF : No. ______
_________________:

NOTICE OF RIGHT OF APPEAL

   A Final Decree has been entered in the above-captioned matter, permanently terminating your parental rights and obligations with regard to the following child or children: The adoption of said child or children may proceed without your further consent or notice.

   You are hereby advised of your right to take an appeal from the Final Decree. Pursuant to Pa.R.A.P. 903, notice of appeal must be filed within thirty (30) days after the entry of the Final Decree.

Rule 15.8.1.  Registration with the Court of Authorized Persons.

   Any agency licensed by the Department of Public Welfare which proposes to accept custody of any child for purposes of relinquishment or adoption under these Rules, shall file with the Clerk a copy of the resolution, certified by the secretary of the agency, setting forth the names and titles of all persons authorized to act or testify on behalf of the Agency in any proceeding before the court.

[Pa.B. Doc. No. 00-55. Filed for public inspection January 7, 2000, 9:00 a.m.]



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