Application for revocation of an order freeing a child for adoption
| Published date | 21 March 2018 |
IN THE COUNTY COURT
No. ............................................
IN THE MATTER OF THE ADOPTION ACT 1976
IN THE MATTER OF
A CHILD
On the ............ day of ..................................... [19 ][20 ] this court made
an order freeing
a child
for adoption.
I/We ............................................................................................................
(and ...........................................................................................................)
of
former parent(s) of the child, apply for revocation of that order on the
grounds that:-
1. No adoption order has been made in respect of the child, and
2. The child does not have his home with a person with whom he has
been placed for adoption, and
3. I/We wish to resume parental responsibility because:-
(continued overleaf if necessary)
Signed ........................................................................................................
(Signed) ......................................................................................................
Dated .........................................................................................................
A4 - w3 Application for revocation of an order freeing a child for adoption On behalf of The Court Service
NOTE: The application must be made
to the court which made the original
order, and not earlier than 12 months
from the date of that order.
NOTE: A parent or guardian of the
child who has made a declaration
(referred to in section 18(6) of the
Adoption Act 1976) that he/she
prefers not to be involved in future
questions concerning the adoption of
the child may not make an application
for revocation of the order.
NOTE: State the reasons relied
upon for the revocation of the order.
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