10
for the said A.B. you will duly receive and be paid all costs, charges and expenses which may be earned or incurred by you in relation to such guardianship or the duties thereof.
Dated the
day of
Signert
10
-
11
"
B. I/We attach a document/documents signifying the consent of the said
(8) to the making of an adoption order upon my/our application.
(8)
tho
of
To:-The Social Welfare Officer, Fire Brigade Building, 1st floor, Hong
Kong
Notes:
41) Delete If an unlicitor is weting for the applicant,
(20
The wards in square brackets are required only if there is more than one partner In the firm of noficitors acting for the upplicant.
1) The undertaking should be signed by the policitor, or by a partner in the firm of solicitors acting for the applicant, or by the applicand if he is meting in persoH.
[9. I/We request the judge to dispense with the consent of the said [9) on the Following grounds
.].
10. The infant was received into my/our care and possession on
19. from
WILLI
........................................... and has been continuously to my/our care and possession since that date.
11. I/We notified the Social Welfare Officer on the 19............................ of my/our intention to apply for an adoption order in respect of the infant,
[12. A certificata as to physical and mental health of the infant. signed by a registered medical practitioner on the
is attached.] 00.
19....
13. I/We have not received or agreed to receive, and no person has made or given or agreed to make or give to me/us, uny payment or other reward in consideration of the adoption [except as follows:
1.
FORM 3.
[rule 9.1
Statement in support of application for an adoption order. 110
[Heading as in form X]
I, the undersigned, C.D./We, the undersigned, C.D. and §.D. desire to adopt 4.8. 2), an Infant, under the Adoption Ordinance, 1956.
of
I am/We are resident in Hong Kong.
3. I am unmarried/a widow/widower/I am married to E.D. We are married to each other and are the persons to whom the attached marriage certificate (or other evidence of marriage) relates.
4. The infant is of the hoodkathond sex and unmarried. He/She was born on the
19......... and is the person to whom the attached birth certificate (*) ́ relates/was born on or about the
19... in
"+
14. I have not made/Neither of us has made a previous application for an adoption order in respect of the same or any other infant to any court court [except an application made to the
19......, which was dealt
at
with as follows:
on the
[15. For the purposes of my/our application reference may be made to NO, of
..) (11.
18. I/We desire that my/our identity should be kept confidential, and the serial number of this application is
........] (3) or [I/We do not desire that my/our identity should be kept confidential).
17. Further particulars of myself/ourselves are set out in the annex to this statement.
18. If an adoption order is made in pursuance of my/our application, it is proposed that the infant should be known as ...........................panese
5. The infant is the child/adopted child 18) of— A.D. of
/whose last known address was ---...............-------..../deceased fand
G.B. of
Dated this........
day of
..../whose last known address was ..../deceased] 4),
......The
[6. The guardian of the infant is H.K. of guardians of the infant are H.K. of .................................................................................... and
J.B. of
17.
L.M. of
ia Hable by virtue of an order
or agreement to contribute to the maintenance of the infant.] (7),
(Onual signature of applicant! applicants)