Form A61
| Published date | 21 March 2018 |
Name of court
Serial no.
Date received by the court
Date issued
Fee charged/Remission ID
Application for an order
for parental responsibility
prior to adoption abroad
Section 84 Adoption and Children
Act 2002
Notes to applicants
• Do not use this form if you intend to apply to a court in England and Wales for an adoption order including a
Convention adoption order.
• Before lling in this form, please read the guidance notes on completing the form.
• Please complete every Part. If you are not sure of the answer to any question, or you do not think that it
applies to you, please say so.
• If there is not enough room on the form for your reply, you may continue on a separate sheet. Please put the
child’s full name, the number of the Part and the paragraph reference at the head of the continuation sheet.
• Please use black ink when lling in the form.
I/We the undersigned
(and )
intend to adopt
under the law of a country or territory outside the British Islands and therefore want to
be given parental responsibility prior to adoption abroad and give the following details in
support of my/our application.
See Note 1
Part 1 About you
First applicant
a) Title
b) My name is
First name(s) in full
Last name
See Note 2
Second applicant
b) My name is
First name(s) in full
Last name
Mr MrsMiss
Ms Other
a) Title
Mr MrsMiss
Ms Other
A61 Application for an order for parental responsibility prior to adoption abroad (11.16) © Crown copyright 2016
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