Adoption Consent Form - Wyoming

WYOMING CONSENT TO ADOPTION AND RELINQUISHMENT OF CUSTODY

Before you use this: Use a separate signed copy for each person whose consent or relinquishment is required. Confirm that the signer has authority under Wyo. Stat. § 1-22-109(a). This form does not replace any required consent of a child over age fourteen. If the child may be an Indian child, follow the Wyoming Indian Child Welfare Act and 25 U.S.C. § 1913 before obtaining consent. An Indian child's parent's consent must be recorded before a judge, with the certifications required by § 1913(a), and cannot be valid if given before or within ten days after birth; the acknowledgment below alone does not suffice. A parent who will remain a parent in a stepparent adoption should use the consent-only choice below and confirm the required documents with counsel and the court.

IN THE DISTRICT COURT OF THE STATE OF WYOMING

[____________________] JUDICIAL DISTRICT, [____________________] COUNTY

1. Child and proposed adoption

Child's current legal name: [________________________________]

Child's date of birth: [__/__/____]

Prospective adopting person(s): [________________________________]

I, [SIGNER'S FULL LEGAL NAME: ________________________________], state that I am signing in this capacity (select one):

☐ Parent of the child who is relinquishing custody for this adoption.

☐ Putative father of the child who is relinquishing custody for this adoption.

☐ Parent who will remain the child's parent while my spouse adopts the child; I give consent only under Section 2A.

☐ Legal guardian of the child's person, where neither parent is living or parental rights have been judicially terminated.

☐ Executive head of the agency to which the child was relinquished for adoption. Agency: [________________________________].

☐ Person having exclusive legal custody of the child under the order dated [__/__/____] of [COURT: ________________________________].

☐ Legally appointed guardian of a parent or putative father adjudged mentally incompetent. Ward and appointing order: [________________________________].

My authority or relationship is shown by [DESCRIPTION OF ORDER, PARENTAGE, OR AGENCY RECORD: ________________________________________________].

2. Consent and relinquishment

2A. Consent. I knowingly and voluntarily consent to the adoption of the child identified above by the proposed adopting person(s). I understand that the court, rather than this document, decides whether to enter an adoption decree.

2B. Relinquishment. If I selected a capacity in Section 1 other than the parent who will remain the child's parent, I relinquish the custody and control of this child that I am legally authorized to relinquish to the proposed adopting person(s) for this adoption. If I selected the remaining-parent capacity, Section 2B does not apply to me.

2C. Understanding. For an adoption outside the Indian Child Welfare Act, I understand that under Wyo. Stat. § 1-22-109(d), consent and relinquishment are irrevocable unless obtained by fraud or duress. If the court denies adoption because of a putative father's claim or objection, the court may allow the mother to withdraw her consent and relinquishment. A minor parent's consent is not revocable solely because the parent is a minor. If this is an Indian child, 25 U.S.C. § 1913(c) allows a parent to withdraw consent for any reason before the final decree of termination or adoption; after a final adoption decree, § 1913(d) addresses fraud or duress challenges. A final adoption decree controls the former parent, guardian, or putative father's rights to control or custody of the child under § 1-22-114(a), subject to applicable Indian child protections.

I have read this instrument, understand the capacity and choice I marked, and sign it voluntarily. I am signing after the child's birth. If this is an Indian child, I am signing more than ten days after birth and before a judge under 25 U.S.C. § 1913(a).

Date signed: [__/__/____]

Signature of consenting person: [________________________________]

Printed name and capacity: [________________________________]

3. Acknowledgment

Indian child: This acknowledgment is not a substitute for the judge's recorded consent and certifications required by 25 U.S.C. § 1913(a). Follow the court's Indian child consent procedure.

State of [____________________], County of [____________________].

This instrument was acknowledged before me on [__/__/____] by [SIGNER'S NAME: ________________________________], who appeared in the capacity marked above.

Signature of authorized acknowledging person: [________________________________]

Printed name and title: [________________________________]

☐ Person authorized to take acknowledgments ☐ Representative of Wyoming Department of Family Services ☐ Representative of certified agency receiving custody for adoption

Agency, if applicable: [________________________________]

Commission expiration, if applicable: [__/__/____]

Filing checks

☐ File the appropriate signed consent and any necessary relinquishment with the adoption petition under Wyo. Stat. §§ 1-22-104(c) and 1-22-109(a).

☐ If the child is over age fourteen, file the child's separate written consent under § 1-22-109(b).

☐ Confirm every required adult signer under § 1-22-109(a), or ask the court to decide any proposed adoption without consent under § 1-22-110. Do not treat this signer's consent as a substitute for another required consent.

Official source: Wyoming Statutes, Title 1, Chapter 22