Adoption Consent Form - Wisconsin

CONSENT TO TERMINATION OF PARENTAL RIGHTS AND ADOPTION

(State of Wisconsin – Wis. Stat. ch. 48)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions
4. Representations & Warranties
5. Covenants & Restrictions
6. Withdrawal of Consent & Revocation Parameters
7. Dispute Resolution
8. General Provisions
9. Acknowledgments & Certifications
10. Execution Block

1. DOCUMENT HEADER

1.1 Title. Consent to Termination of Parental Rights and Adoption (“Consent”).

1.2 Parties.
(a) “[FULL LEGAL NAME]” (“Consenting Parent”).
(b) “[FULL LEGAL NAME]” (“Child”), born on [DATE OF BIRTH] at [HOSPITAL/CITY], Wisconsin.
(c) “[FULL LEGAL NAME(S)]” (“Prospective Adoptive Parent(s)”) [optional].
(d) “[NAME OF LICENSED CHILD-PLACING AGENCY]” (“Agency”) [if applicable].

1.3 Effective Date. This Consent is effective on the date it is executed before the Court as required by Wis. Stat. § 48.41(2).

1.4 Governing Law & Court. This Consent is governed by Wisconsin law and is submitted in the termination-of-parental-rights proceeding in the [COUNTY] Circuit Court assigned to hear the matter under Wis. Stat. ch. 48 (the “Court”). Confirm the proper county and venue before filing.

2. DEFINITIONS

For purposes of this Consent:

“Agency” means the licensed Wisconsin child-placing agency identified above or any successor entity approved by the Court.

“Child” has the meaning set forth in Section 1.2(b).

“Court” has the meaning set forth in Section 1.4.

“Counselor” means a qualified adoption counselor or social worker who provides any counseling the Consenting Parent elects to receive, as referenced in Section 3.4. Wisconsin does not require a minimum number of counseling sessions as a condition of a valid consent.

“Consenting Parent” has the meaning set forth in Section 1.2(a).

“Prospective Adoptive Parent(s)” has the meaning set forth in Section 1.2(c).

3. OPERATIVE PROVISIONS

3.1 Voluntary Consent. Consenting Parent hereby voluntarily and knowingly consents to:
(a) the termination of all parental rights to the Child; and
(b) the placement of the Child for adoption by the Agency or directly with the Prospective Adoptive Parent(s).

3.2 Timing Requirement. Consent to a voluntary termination of parental rights is ordinarily given by the Consenting Parent’s personal appearance before the Court at a hearing (Wis. Stat. § 48.41(2)(a)). Where the Child is placed for adoption with nonrelatives, the Court holds the hearing within 30 days after the petitions are filed, except that the hearing may not be held before the birth of the Child (Wis. Stat. § 48.837(4)(a)). There is no general 72-hour post-birth waiting rule for voluntary consent; that 72-hour reference concerns a ground for involuntary termination under Wis. Stat. § 48.415. For an Indian child, consent given before or within 10 days after birth is invalid under Wis. Stat. §§ 48.41(2)(e) and 48.028(5)(b). Is the Child an Indian child for these provisions? ☐ Yes ☐ No ☐ To be determined. Date and time of the Child’s birth: ______________. Date and time of proposed consent: ______________.

3.3 Court Appearance. Consenting Parent acknowledges that:
(a) this Consent must be reaffirmed personally before the Court; and
(b) the Court will determine whether the Consent is informed and voluntary, and may accept it only after the judge has explained the effect of termination and questioned the Consenting Parent, as required by Wis. Stat. § 48.41(2)(a).

3.4 Counseling (Optional).
(a) Wisconsin does not require the Consenting Parent to complete or be offered any minimum number of counseling sessions as a condition of a valid consent. Any pre-adoptive or post-adoptive counseling the Consenting Parent elects to receive is among the expenses the Prospective Adoptive Parent(s) may lawfully pay under Wis. Stat. § 48.913(1).
(b) If counseling was received, session date(s): ____________________________.
(c) If a Counselor Certificate is provided, it is attached at Section 9.2; no such certificate is required for this Consent to be valid.

3.5 Consideration. No monetary consideration, material promise, or inducement has been offered or accepted by the Consenting Parent other than permissible adoption-related expenses authorized by Wis. Stat. § 48.913.

4. REPRESENTATIONS & WARRANTIES

Consenting Parent represents and warrants to the Court and the Agency that:

a. Parentage & Authority. Consenting Parent is the Child’s legal [mother/father] and has full legal capacity to execute this Consent.
b. Absence of Coercion. No fraud, duress, or undue influence has been exerted.
c. Exclusive Rights. No other person holds custodial or parental rights to the Child, except as disclosed in Schedule 1 (Other Potential Parents) attached hereto.
d. Substance Capacity. Consenting Parent is not under the influence of any impairing substance.
e. Representation. Consenting Parent has had the opportunity to consult independent counsel. If the Consenting Parent is under 18 and petitions for voluntary termination, a guardian ad litem must represent the parent under Wis. Stat. § 48.23(2)(a). In a contested adoption or involuntary termination proceeding, a parent under 18 may not waive counsel under § 48.23(2)(b). This Consent does not waive any representation required by law; the Court determines whether any other waiver of counsel is permitted.

5. COVENANTS & RESTRICTIONS

a. Future Cooperation. Consenting Parent shall execute any further documents reasonably required to effectuate the adoption.
b. Contact Provisions. Entry of the TPR Order severs all parental rights, including any right to contact or visitation (Wis. Stat. § 48.40(2)). Wisconsin does not provide a generally enforceable open-adoption/post-adoption-contact statute; any future contact with the Child shall occur only as permitted by subsequent court order or as otherwise authorized by law.
c. Confidentiality. Consenting Parent shall maintain confidentiality of identifying information concerning Prospective Adoptive Parent(s) unless disclosure is authorized by law or court order.

6. WITHDRAWAL OF CONSENT & REVOCATION PARAMETERS

6.1 Request Before Judgment.
If Consenting Parent seeks to retract consent before the Court enters an order terminating parental rights (the “TPR Order”), Consenting Parent must raise the issue promptly with the Court. For a child who is not an Indian child under Wis. Stat. § 48.028, this form does not create a unilateral right or an automatic petition procedure to withdraw consent. The Court determines the effect of the request under applicable law; after accepting informed and voluntary consent, it may proceed immediately to disposition under Wis. Stat. § 48.41(1). For an Indian child, a parent may withdraw consent for any reason before the final TPR order under Wis. Stat. § 48.028(5)(b) and 25 U.S.C. § 1913(c); the child's return is subject to any applicable prior placement order or agreement identified in § 48.028(5)(b).

6.2 Effect of TPR Order.
Upon entry of the TPR Order, the order takes effect. Post-judgment routes include the following, with additional protections for an Indian child:
a. a notice of intent to pursue postdisposition or appellate relief, filed with the circuit court clerk and served on the required recipients within thirty (30) days after entry of the judgment or order (Wis. Stat. § 809.107(2)(bm)); and
b. a motion for relief from the judgment under Wis. Stat. § 48.46(2), limited to the grounds in Wis. Stat. § 806.07(1)(a), (b), (c), (d), or (f) (mistake, newly discovered evidence, fraud/misrepresentation/misconduct, void judgment, or reversed prior judgment), which must be filed within 30 days after entry of the judgment unless a timely notice of intent under par. (a) is filed.
c. For an Indian child, a parent may seek invalidation under Wis. Stat. § 48.028(6). After a final adoption order, a parent whose consent was obtained by fraud or duress may seek to withdraw that consent and vacate the order under § 48.028(5)(c) and 25 U.S.C. § 1913(d). Wisconsin requires that motion within two years after entry of the adoption order.

6.3 Procedure.
Motions and petitions under Section 6.2 must comply with Wis. Stat. § 48.46 and be served upon all parties of record. A motion under § 48.46(2) does not suspend the operation of the TPR Order.

7. DISPUTE RESOLUTION

Because matters relating to adoption are within the exclusive jurisdiction of state courts:

a. Governing Law: State of Wisconsin.
b. Court: [COUNTY] Circuit Court assigned to hear the ch. 48 proceeding; confirm venue under Wis. Stat. § 48.185 before filing.
c. Arbitration: Not available.
d. Jury Waiver: All issues are to be decided by the Court sitting without a jury, consistent with “no_jury_family_court.”
e. Injunctive Relief: The Court retains authority to enter any orders necessary for permanent placement and the best interests of the Child.

8. GENERAL PROVISIONS

8.1 Entire Agreement. This Consent, including all attachments, constitutes the entire agreement regarding the matters herein and supersedes any prior statements.

8.2 Amendments. May be amended only in a writing executed by the Consenting Parent and approved by the Court before the TPR Order.

8.3 Severability. Any unenforceable provision shall be severed, and the remainder enforced to the fullest extent permitted by law.

8.4 Execution; No Electronic Signature. This Consent must be executed in the manner required by Wis. Stat. § 48.41(2) — by the Consenting Parent’s personal appearance before the Court, or, only where the statutory conditions are met, by one of the alternatives in § 48.41(2)(b)–(d) (written consent before a qualifying official with accompanying findings; a putative father’s notarized statement under (2)(c); or, in a stepparent/foreign-jurisdiction case, an affidavit witnessed by 2 persons under (2)(d)). Wisconsin’s Uniform Electronic Transactions Act does not apply to records governed by any law relating to adoption or other matters of family law, to court orders, or to official court documents required to be executed in connection with court proceedings (Wis. Stat. § 137.12(2m)(a), (c), (d)). An electronic signature therefore does not satisfy the execution requirements for this Consent.

9. ACKNOWLEDGMENTS & CERTIFICATIONS

9.1 Statement of Parental Rights (Wis. Stat. § 48.41(2)(a))

The Court may accept this Consent only after the judge has explained the effect of termination of parental rights, has questioned the Consenting Parent (or permitted an attorney for a party to do so), and is satisfied that the Consent is informed and voluntary (Wis. Stat. § 48.41(2)(a)). I, the Consenting Parent, acknowledge that the following has been read aloud to me by the Court (or that I have personally read and understood it):

1. I understand that signing this document may permanently end my parental rights to the Child.
2. I understand that, if the Child is an Indian child, I may withdraw consent for any reason before a final TPR order under Wis. Stat. § 48.028(5)(b). In other cases, this form does not give me an automatic right to withdraw consent before judgment; I must tell the Court promptly if I seek to retract consent. After a TPR judgment, any request for relief must follow applicable law, including Wis. Stat. §§ 48.028 and 48.46(2) where applicable.
3. I understand that the Child may be adopted by the Prospective Adoptive Parent(s) or another suitable adoptive parent.
4. I understand that I may retain independent counsel at my own expense and that any required or appointed representation depends on Wis. Stat. § 48.23 and the type of proceeding. Optional pre-adoptive or post-adoptive counseling may be paid for by proposed adoptive parents under § 48.913(1)(a)-(b); this Consent does not promise counseling without cost to me.
5. I have received a copy of this signed Consent.

Initials of Consenting Parent: _________

9.2 Counselor Certificate

I, [COUNSELOR NAME], certify that I am qualified under Wisconsin law and that:
☐ The Consenting Parent attended the counseling sessions listed in Section 3.4(b); OR
☐ The Consenting Parent knowingly and voluntarily declined such sessions.

Signature of Counselor: _________________________ Date: _____________

10. EXECUTION BLOCK

IN WITNESS WHEREOF, the undersigned executes this Consent as of the Effective Date.

Notary Block — putative father’s written statement under Wis. Stat. § 48.41(2)(c) only (not for a parent’s in-court consent under § 48.41(2)(a)):

State of Wisconsin )
County of [________________________________] )

Subscribed and sworn to before me on ____________, 20___, by _____________________________, who is personally known to me or who presented satisfactory evidence of identity.

________________________________________
Notary Public, State of Wisconsin
My Commission Expires: ________________

COURT APPROVAL

Presented to the Court this ____ day of ____________, 20__.

The Court finds that the Consenting Parent’s consent is informed, voluntary, and in compliance with Wis. Stat. § 48.41. The Court hereby accepts the Consent.

________________________________________
Circuit Court Judge

Case No.: _________________