The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

PETITION FOR THE
ADOPTION OF A MINOR

DOCKET NUMBER

Trial Court of Massachusetts
Juvenile Court Department

DIVISION

 (If petitioner is married, his/her spouse must sign the petition.)

Petitioner No. 1

(PRINT name of petitioner)

(street address)

Petitioner No. 2

(PRINT name of petitioner)

(street address)

(city or town/state/zip code)

(county)

(city or town/state/zip code)

(county)

(telephone number)

(telephone number)

state that they are (he/she is) desirous of adopting the following child:

1.

Date of Birth:

(name of child)

Place of Birth:

(name of mother or parent No. 1)

(name of father or parent No. 2)

(street address)

(street address)

(city or town/state/zip code)

(city or town/state/zip code)

2.  The petitioner(s) is(are) of sufficient ability to rear the child, and to provide suitable support and education for the child;
     and

3.          the child has resided for at least six months in the home of the petitioner(s).
             the child was the subject of a proceeding pursuant to M. G. L. c. 210, § 3 or pursuant to M. G. L. c. 119, § 26 wherein
             the Court dispensed with the need for consent or notice to the parent(s) on a petition for adoption.
             the child was the subject of a surrender which was executed pursuant to M. G. L. c. 210, § 2.  At the time of her
             surrender, the mother was                years old.  At the time of his surrender, the father was                years old.
             the child is a blood relative or stepchild of the petitioner(s).
             the child is in the care and custody of the petitioner(s).

WHEREFORE, they (he/she) request(s) that the Court, grant them (him/her) leave to adopt said child; and (if applicable)

             waive the residence requirement for good cause:  (explain)

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

             decree that said child's name be changed to that of

Date:

Signature of Petitioner No. 1

Signature of Spouse/Petitioner No. 2

JV-131  (Rev. 12/30/2013)

Page 1 of 2

This petition is sponsored, recommended and approved by
a charitable corporation organized under the laws of the Commonwealth of Massachusetts for the purpose of engaging in
the care of children and principally so engaged.

I,                                                                             , being above the age of twelve years hereby consent to this adoption as

requested above.

(PRINT name of child)

Date:

CHILD'S CONSENT

Signature:

NOTARIZATION

The above named child                                                                          made an oath before me on

(name of child)

(date)

that this consent is his/her free act and deed.

Date:

Print Name:

Signature:

My Commission Expires:

AFFIDAVIT OF PETITIONER(S) FOR ADOPTION

Petitioner No. 1

Petitioner No. 2

(PRINT name of petitioner, including maiden name if applicable)

(PRINT name of petitioner)

(street address)

(street address)

(city or town/state/zip code)

(city or town/state/zip code)

(telephone number)

(date of birth)

(telephone number)

(date of birth)

(place of birth:  city/town, state, county, country)

(place of birth:  city/town, state, county, country)

(occupation at the time of adoption)

(occupation at the time of adoption)

I (We) hereby request that a certificate of this adoption be sent to the city or town clerk of the place of birth of the child, and
that the clerk of the records amend the birth certificate of the child to reflect this adoption.

Signature of Petitioner No. 1

Signature of Petitioner No. 2

NOTARIZATION

The above signed made oath before me on

The above signed made oath before me on

that this affidavit is his/her free act and deed.

that this affidavit is his/her free act and deed.

Notary Public:

Print Name:

Notary Public:

Print Name:

My Commission Expires:

My Commission Expires:

JV-131  (Rev. 12/30/2013)

Page 2 of 2

Petition for Adoption of a Minor

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Massachusetts state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.mass.gov (2023-03)
Page(s): 2
Fields(s): 73
Average fields per page: 36
Reading Level: Grade 7
LIST Grouping(s): GO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

transaction_set_date_field__1 was transaction[0].#pageSet[0].Page1[0].UntitledSubform[0].Date[0].TextField2[0] (0.59 conf)
transaction_set_field__1 was transaction[0].#pageSet[0].Page1[0].UntitledSubform[0].Signature[0].TextField2[0] (0.42 conf)
transaction_set_field__2 was transaction[0].#pageSet[0].Page1[0].UntitledSubform[0].Signature[0].TextField2[1] (0.42 conf)
transaction_page_case was transaction[0].Page1[0].case[0] (0.37 conf)
transaction_data_drop_list was transaction[0].Page1[0].DataDropDownList[0] (0.36 conf)
transaction_page_name_child was transaction[0].Page1[0].Name_of_Child[0] (0.40 conf)
parents_mother_name was transaction[0].Page1[0].Parents[0].Mother_Name[0] (0.39 conf)
page_parents_name was transaction[0].Page1[0].Parents[0].Father_Name[0] (0.37 conf)
parents_mother_address__1 was transaction[0].Page1[0].Parents[0].Mother_Address1[0] (0.39 conf)
transaction_parents_address__1 was transaction[0].Page1[0].Parents[0].Father_Address1[0] (0.37 conf)
parents_mother_address__2 was transaction[0].Page1[0].Parents[0].Mother_Address2[0] (0.39 conf)
transaction_parents_address__2 was transaction[0].Page1[0].Parents[0].Father_Address2[0] (0.37 conf)
transaction_page_phone_num__1 was transaction[0].Page1[0].Parents[0].PhoneNum[0] (0.37 conf)
transaction_page_phone_num__2 was transaction[0].Page1[0].Parents[0].PhoneNum[1] (0.37 conf)
parents_mother_address__3 was transaction[0].Page1[0].Parents[0].Mother_Address2[1] (0.39 conf)
transaction_parents_address__3 was transaction[0].Page1[0].Parents[0].Father_Address2[1] (0.37 conf)
transaction_page_text_field__1 was transaction[0].Page1[0].TextField3[0] (0.41 conf)
transaction_page_text_field__2 was transaction[0].Page1[0].TextField3[1] (0.41 conf)
transaction_page_subform_mother_name__1 was transaction[0].Page1[0].#subform[1].Mother_Name[0] (0.38 conf)
transaction_page_subform_father_name__1 was transaction[0].Page1[0].#subform[1].Father_Name[0] (0.35 conf)
transaction_page_address__1 was transaction[0].Page1[0].#subform[1].Mother_Address1[0] (0.38 conf)
transaction_page_address__2 was transaction[0].Page1[0].#subform[1].Father_Address1[0] (0.35 conf)
transaction_page_address__3 was transaction[0].Page1[0].#subform[1].Mother_Address2[0] (0.38 conf)
transaction_page_address__4 was transaction[0].Page1[0].#subform[1].Father_Address2[0] (0.35 conf)
transaction_page_address__5 was transaction[0].Page1[0].#subform[1].Father_Address2[1] (0.35 conf)
transaction_page_address__6 was transaction[0].Page1[0].#subform[1].Mother_Address2[1] (0.38 conf)
transaction_page_yes_check_box__1 was transaction[0].Page1[0].Yes_CheckBox1[0] (0.41 conf)
transaction_page_yes_check_box__2 was transaction[0].Page1[0].Yes_CheckBox1[1] (0.41 conf)
transaction_page_yes_check_box__3 was transaction[0].Page1[0].Yes_CheckBox1[2] (0.41 conf)
transaction_page_yes_check_box__4 was transaction[0].Page1[0].Yes_CheckBox1[3] (0.41 conf)
transaction_page_yes_check_box__5 was transaction[0].Page1[0].Yes_CheckBox1[4] (0.41 conf)
transaction_page_text_field__3 was transaction[0].Page1[0].TextField4[0] (0.41 conf)
transaction_page_text_field__4 was transaction[0].Page1[0].TextField4[1] (0.41 conf)
transaction_page_yes_check_box__6 was transaction[0].Page1[0].Yes_CheckBox1[5] (0.41 conf)
transaction_page_text_field__5 was transaction[0].Page1[0].TextField5[0] (0.41 conf)
transaction_page_yes_check_box__7 was transaction[0].Page1[0].Yes_CheckBox1[6] (0.41 conf)
transaction_page_address__7 was transaction[0].Page1[0].Father_Address2[2] (0.35 conf)
transaction_set_date_field__2 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].Date[0].TextField2[0] (0.42 conf)
transaction_set_text_field__1 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].#subform[1].TextField2[0] (0.40 conf)
transaction_set_date_field__3 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].Date[1].TextField2[0] (0.42 conf)
transaction_set_text_field__2 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].#subform[3].TextField2[1] (0.40 conf)
transaction_set_text_field__3 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].#subform[4].TextField2[2] (0.40 conf)
transaction_set_text_field__4 was transaction[0].#pageSet[0].Page2[0].UntitledSubform[0].#subform[5].TextField2[3] (0.40 conf)
transaction_page_mother_name__1 was transaction[0].Page2[0].Mother_Name[0] (0.38 conf)
transaction_page_day was transaction[0].Page2[0].Day1[0] (0.38 conf)
transaction_page_mother_name__2 was transaction[0].Page2[0].Mother_Name[1] (0.38 conf)
transaction_page_mother_name__3 was transaction[0].Page2[0].Mother_Name[2] (0.38 conf)
transaction_page_notary was transaction[0].Page2[0].Notary1[0] (0.38 conf)
transaction_page_commission was transaction[0].Page2[0].Commission1[0] (0.38 conf)
transaction_page_subform_mother_name__2 was transaction[0].Page2[0].#subform[0].Mother_Name[3] (0.38 conf)
transaction_page_subform_father_name__2 was transaction[0].Page2[0].#subform[0].Father_Name[0] (0.35 conf)
transaction_page_address__8 was transaction[0].Page2[0].#subform[0].Mother_Address1[0] (0.38 conf)
transaction_page_address__9 was transaction[0].Page2[0].#subform[0].Father_Address1[0] (0.35 conf)
transaction_page_address__10 was transaction[0].Page2[0].#subform[0].Mother_Address2[0] (0.38 conf)
transaction_page_address__11 was transaction[0].Page2[0].#subform[0].Father_Address2[0] (0.35 conf)
transaction_page_phone_num__3 was transaction[0].Page2[0].#subform[0].PhoneNum[0] (0.37 conf)
transaction_page_phone_num__4 was transaction[0].Page2[0].#subform[0].PhoneNum[1] (0.37 conf)
transaction_page_address__12 was transaction[0].Page2[0].#subform[0].Mother_Address2[1] (0.38 conf)
transaction_page_address__13 was transaction[0].Page2[0].#subform[0].Father_Address2[1] (0.35 conf)
transaction_page_address__14 was transaction[0].Page2[0].#subform[0].Mother_Address2[2] (0.38 conf)
transaction_page_address__15 was transaction[0].Page2[0].#subform[0].Mother_Address2[3] (0.38 conf)
transaction_page_address__16 was transaction[0].Page2[0].#subform[0].Mother_Address2[4] (0.38 conf)
transaction_page_address__17 was transaction[0].Page2[0].#subform[0].Mother_Address2[5] (0.38 conf)
transaction_page_address__18 was transaction[0].Page2[0].#subform[0].Mother_Address2[6] (0.38 conf)
transaction_page_address__19 was transaction[0].Page2[0].#subform[0].Mother_Address2[7] (0.38 conf)
transaction_page_subform_mother_name__3 was transaction[0].Page2[0].#subform[1].Mother_Name[4] (0.38 conf)
transaction_page_subform_mother_name__4 was transaction[0].Page2[0].#subform[1].Mother_Name[5] (0.38 conf)
transaction_page_subform_mother_name__5 was transaction[0].Page2[0].#subform[1].Mother_Name[6] (0.38 conf)
transaction_page_subform_mother_name__6 was transaction[0].Page2[0].#subform[1].Mother_Name[7] (0.38 conf)
transaction_page_subform_mother_name__7 was transaction[0].Page2[0].#subform[2].Mother_Name[8] (0.38 conf)
transaction_page_subform_mother_name__8 was transaction[0].Page2[0].#subform[2].Mother_Name[9] (0.38 conf)
transaction_page_subform_mother_name__9 was transaction[0].Page2[0].#subform[2].Mother_Name[10] (0.38 conf)
transaction_page_subform_mother_name__10 was transaction[0].Page2[0].#subform[2].Mother_Name[11] (0.38 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

transaction_set_date_field__1
transaction_set_field__1
transaction_set_field__2
transaction_page_case
transaction_data_drop_list
transaction_page_name_child
parents_mother_name
page_parents_name
parents_mother_address__1
transaction_parents_address__1
parents_mother_address__2
transaction_parents_address__2
transaction_page_phone_num__1
transaction_page_phone_num__2
parents_mother_address__3
transaction_parents_address__3
transaction_page_text_field__1
transaction_page_text_field__2
transaction_page_subform_mother_name__1
transaction_page_subform_father_name__1
transaction_page_address__1
transaction_page_address__2
transaction_page_address__3
transaction_page_address__4
transaction_page_address__5
transaction_page_address__6
transaction_page_yes_check_box__1
transaction_page_yes_check_box__2
transaction_page_yes_check_box__3
transaction_page_yes_check_box__4
transaction_page_yes_check_box__5
transaction_page_text_field__3
transaction_page_text_field__4
transaction_page_yes_check_box__6
transaction_page_text_field__5
transaction_page_yes_check_box__7
transaction_page_address__7
transaction_set_date_field__2
transaction_set_text_field__1
transaction_set_date_field__3
transaction_set_text_field__2
transaction_set_text_field__3
transaction_set_text_field__4
transaction_page_mother_name__1
transaction_page_day
transaction_page_mother_name__2
transaction_page_mother_name__3
transaction_page_notary
transaction_page_commission
transaction_page_subform_mother_name__2
transaction_page_subform_father_name__2
transaction_page_address__8
transaction_page_address__9
transaction_page_address__10
transaction_page_address__11
transaction_page_phone_num__3
transaction_page_phone_num__4
transaction_page_address__12
transaction_page_address__13
transaction_page_address__14
transaction_page_address__15
transaction_page_address__16
transaction_page_address__17
transaction_page_address__18
transaction_page_address__19
transaction_page_subform_mother_name__3
transaction_page_subform_mother_name__4
transaction_page_subform_mother_name__5
transaction_page_subform_mother_name__6
transaction_page_subform_mother_name__7
transaction_page_subform_mother_name__8
transaction_page_subform_mother_name__9
transaction_page_subform_mother_name__10

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Petition for Adoption of a Minor

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02