Adoption Consent Form - Preparation Worksheet - New Jersey

NEW JERSEY ADOPTION CONSENT ROUTE-SELECTION AND PREPARATION PACKET

Not an operative surrender or consent. New Jersey does not use one private contract for every adoption. An approved-agency surrender must be prepared and taken by the approved agency. A direct placement requires a Family Part voluntariness hearing. Do not sign this packet as a substitute for the route-specific instrument, testimony, complaint, notice, or court order.

1. Matter Information

Child's current legal name: [________________________________]

Child's date and place of birth: [__/__/____], [________________________________]

Birth or legal parent completing this packet: [________________________________]

Other legal or alleged parent(s): [________________________________]

Prospective adoptive parent(s): [________________________________]

New Jersey counsel: [________________________________]

Approved adoption agency, if any: [________________________________]

Expected county and court matter number, if known: [________________________________]

2. Select the Legal Route Before Preparing Any Signature Page

Select one route after counsel and, where applicable, the approved agency review the facts.

Route A — Approved-Agency Surrender

☐ The child will be surrendered to a New Jersey approved agency for adoption.

☐ The agency will prepare and take its own surrender instrument under N.J.S.A. 9:3-41.

☐ The agency has confirmed that the child will be more than 72 hours old when the birth parent signs.

☐ The agency has identified its representative who will acknowledge the surrender.

☐ A different person will act as notary; the agency representative and notary will not be the same person.

☐ The agency has completed and documented the counseling process required by N.J.A.C. 3A:50-5.4(c), or the parent's documented refusal to participate.

☐ The agency has explained that the surrender transfers custody to the agency, permits the agency to consent to adoption, permanently ends the parent-child relationship, and is not governed by a general post-signing revocation period.

☐ If the parent requests a conditional surrender to identified prospective adoptive parent(s), the agency has accepted or declined that request and documented the result.

Agency contact: [________________________________]

Scheduled surrender date, time, and place: [________________________________]

Child's age at scheduled signing: [________________________________]

Route B — Direct or Independent Placement

☐ The child was not received from an approved agency.

☐ Counsel will prepare and file the adoption complaint required by N.J.S.A. 9:3-48(a).

☐ Counsel will request the orders and approved-agency investigation required for a non-agency placement.

☐ The birth or legal parent will appear at the Superior Court, Chancery Division, Family Part hearing required by N.J.S.A. 9:3-45(b)(4).

☐ Counsel will prepare the parent to testify, personally and without scripted assurances, about voluntariness and the consequences listed in N.J.S.A. 9:3-45(e).

☐ No private signature page in this packet will be presented as the court's voluntariness determination or as a substitute for the hearing.

Child's placement date: [__/__/____]

Person who arranged or assisted with placement: [________________________________]

Approved agency proposed for the court-ordered investigation: [________________________________]

Expected hearing date, if assigned: [__/__/____]

Route C — Another Proceeding

☐ Stepparent, relative, interstate, foreign, DCPP, prior termination, prior agency surrender, or another route applies.

Route and controlling order or instrument: [________________________________]

Reason this packet is being used only as an intake aid: [________________________________]

3. Parent Identity and Authority Review

☐ Parent's government-issued identification reviewed.

☐ Parent's legal relationship to the child confirmed from the birth record, acknowledgment, adjudication, marriage presumption, adoption judgment, guardianship order, or other reviewed authority.

☐ Every other legal, presumed, alleged, or putative parent has been identified for counsel's notice-and-rights analysis.

☐ No person has represented that this parent's signature alone eliminates another person's rights.

☐ Any existing custody, guardianship, child-protection, support, parentage, restraining-order, or interstate order has been provided to counsel and the agency.

Documents reviewed:

4. Voluntariness and Communication Safeguards

Complete this section outside the presence of prospective adoptive parents and any person whose presence could affect the parent's answers.

☐ The parent has had a private opportunity to ask questions of counsel and, for Route A, agency staff.

☐ The parent states that no person has threatened, coerced, pressured, or improperly induced the decision.

☐ The parent has disclosed all payments, promised payments, reimbursements, gifts, loans, housing, medical costs, legal fees, and other benefits connected with the pregnancy, placement, or adoption.

☐ The parent has received an explanation of alternatives to adoption and available community resources.

☐ The parent has been offered the route-specific counseling required by the approved agency, if Route A applies.

☐ An interpreter or communication accommodation is not needed; OR

☐ The following qualified interpreter or accommodation will be used: [________________________________]

☐ The parent is not signing while impaired by medication, anesthesia, substances, acute medical distress, or another condition that prevents meaningful understanding.

Private interview notes and unresolved concern: [________________________________]

5. Required Consequence Review

Counsel or the approved agency should explain each item in plain language and record questions. Checking a box is not the operative surrender or court finding.

☐ The selected process concerns permanent parental rights, not temporary custody or informal caregiving.

☐ Under Route A, the approved agency—not the prospective adoptive parents—takes the surrender and obtains authority to consent to adoption.

☐ Under Route A, the verified law does not create a general 72-hour revocation period after signing. The 72-hour rule is a minimum age-of-child gate before the birth parent's agency surrender may be taken.

☐ Under Route A, the surrender is generally irrevocable when validly executed, subject to the approved agency's discretion or a court order based on the statutory grounds.

☐ Under Route B, the court must hear the surrendering parent and determine that the decision is voluntary and proper.

☐ Under Route B, the parent understands that court acceptance permanently ends the parent-child relationship and contact, terminates parental rights, constitutes consent to adoption, and ends further notice of the adoption proceeding.

☐ The parent has discussed any requested future contact, identifying-information preference, or openness arrangement with counsel and understands that it must be handled through the proper adoption process, not through a generic contract remedy in this packet.

Parent's questions and answers provided: [________________________________]

6. Agency-Surrender Preparation Record — Route A Only

6.1 Counseling and Information

6.2 Execution Logistics

Agency surrender form version: [________________________________]

Agency representative: [________________________________]

Separate notary: [________________________________]

Persons expected to be present: [________________________________]

Signing location: [________________________________]

Plan for documenting demeanor, competence, and absence of coercion: [________________________________]

7. Direct-Placement Hearing Preparation — Route B Only

7.1 Court and Investigation File

☐ Adoption complaint prepared by counsel.

☐ Placement history and identity of every intermediary documented.

☐ Proposed approved agency identified for the court-ordered investigation.

☐ Home, household-member, background, medical-history, and other investigation materials assembled as directed by counsel and the appointed agency.

☐ Required service, notice, waiver, objection, and diligent-search issues separately analyzed by counsel.

7.2 Parent's Hearing Topics

The parent should be ready to answer the court's questions truthfully about:

☐ identity and relationship to the child;

☐ whether the decision is voluntary;

☐ whether any threat, pressure, promise, payment, or undisclosed agreement influenced the decision;

☐ understanding that the hearing concerns permanent surrender of birth rights;

☐ understanding that acceptance permanently ends the parent-child relationship and contact;

☐ understanding that acceptance terminates parental rights and supplies consent to adoption; and

☐ understanding that no further notice of the adoption proceeding will be provided after the court accepts the surrender.

Documents counsel expects the parent to bring: [________________________________]

Unresolved question for the court or appointed agency: [________________________________]

8. Stop Conditions

Do not proceed to a route-specific signing or hearing until counsel and the responsible agency or court address every checked item.

☐ Parent identity or legal-parent status is uncertain.

☐ Another parent's identity, location, notice rights, or consent status is unresolved.

☐ Child is not yet old enough for a Route A surrender.

☐ Required agency counseling, refusal documentation, or explanation is incomplete.

☐ Parent requests more time, independent advice, counseling, an interpreter, or a private interview.

☐ Coercion, payment, impairment, medical condition, family violence, trafficking, or undue-influence concern exists.

☐ Existing court, custody, guardianship, child-protection, or interstate orders have not been reviewed.

☐ The proposed form, witness, acknowledgment, notary, or hearing procedure does not match the selected route.

Responsible person and next action: [________________________________]

9. Preparation Acknowledgment — Not a Consent or Surrender

By signing below, the signer acknowledges only that this preparation packet was reviewed. The signature does not surrender parental rights, consent to adoption, transfer custody, waive notice, create a revocation period, or replace an approved-agency instrument or judicial hearing.

Parent: [________________________________] Date: [__/__/____]

Attorney or approved-agency representative: [________________________________] Date: [__/__/____]

Interpreter, if used: [________________________________] Date: [__/__/____]

Sources and References

• New Jersey Law Revision Commission, Tentative Report Addressing “Surrender” in the Context of Voluntary Relinquishment of Parental Rights (Sept. 26, 2024) — reproduces the operative text of N.J.S.A. 9:3-41, 9:3-45, and 9:3-48 reviewed for this packet.
• New Jersey Department of Children and Families, N.J.A.C. 3A:50 Manual of Requirements for Adoption Agencies — effective March 24, 2023 and expiring March 24, 2030; see N.J.A.C. 3A:50-5.4.