Application for a Placement Order (Section 22 Adoption and Children Act 2002)

Published date21 March 2018
Subject MatterAdoption forms
Application for a
placement order
Name of court
Case no.
Date received by the court
Date issued
Fee charged/Remission ID
Notes to applicants
• Before lling in this form, please read the guidance notes on completion.
• Please complete every item. If any item does not apply to your application, or you do not have the
necessary information, please say so.
• If there is not enough room for your reply to any question, please continue on a separate sheet.
Please put the child’s name, the Part and the number of the question at the head of the continuation sheet.
• Please do not include information about an adoption order for an adopted brother or sister that has
been made or applied for.
• Please do not attach to this application copies of adoption orders for any adopted brother or sister.
• Use black ink when lling in the form.
Part 1 About you
1) Title
2) My name is
First name(s) in full
3) I am an authorised ofcer of (give name and address (including postcode) of local authority)
Last name
4) My telephone number is
6) My solicitor in these proceedings is
Mr Mrs Miss Ms Other
Name of solicitor
Name of firm
Address
(including postcode)
Telephone no. Fax no.
DX no.
E-mail address
Fee account no.
5) My position in the local authority is
A50 Application for a placement order Section 22 Adoption and Children Act 2002 (11.14) © Crown copyright 2014
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