IN THE COURT OF COMMON PLEAS 

___________________ COUNTY, PENNSYLVANIA 

ORPHANS' COURT DIVISION 

(FAMILY COURT DIVISION in Philadelphia County) 

IN RE: FOREIGN ADOPTION OF __________________ 

FILE NO. _____________ 

PETITION TO REGISTER FOREIGN ADOPTION DECREE 

PURSUANT TO 23 Pa. C.S. § 2908 

Petitioner(s),  the  Adopting  Parent(s)  of  the  above-named  adopted  child,
is/are

reside(s) 

in 

________________________  County,

1.

2.

3.

Petitioner(s) 
Pennsylvania, at

 

(Street Address) 

(City, State, Zip) 

Has any other court in this Commonwealth or in any other state reviewed,
registered,  finalized  or  otherwise  assumed  jurisdiction  over  the  foreign
adoption decree being registered here:

(check one)            Yes           No

If  yes,  please  provide  the  name  of  the  court,  the  state  and  county,  what
was  previously  presented  to  the  court  and  the  resulting  decision  from  the
court  (attach all court decrees).

Form A-07 Rev. 07/01/22

1The  full  name  of  the  adopted  child  at  birth  as  listed  on  the  foreign  birth
____.
certificate, if available, was  

The full name of the adopted child as written on the foreign adoption
decree is

The full name of the adopted child as he or she is to be known from this
time forward is

The date of birth of the adopted child is

The date of the foreign adoption decree is

. 

. 

4.

5.

6.

7.

8.

9.

The type of United States visa issued to the adopted child is:

(check one)      

 IR-2,        IR-3,        IH-3,        IR-4,        IH-4

10.

The following documents are attached to this Petition:

a.

b.

c.

d.

e.

f.

Copy  of  child’s  birth  certificate  or  other  birth  identification
issued  by  country  of  birth;  if  none,  an  affidavit  of  adopting
parent(s)  stating why none is available.

Copy of Decree of Adoption issued by foreign government; if
Decree  is  not  in  English,  an  English  translation  certified  by
the translator to be true and correct.

Copy of adopted child’s United States visa.

Pennsylvania  Department  of  Health,  Division  of  Vital
Records  Form  No.  HD01273F,  Certificate  of  Adoption  of  a
Foreign-Born  Child  with  Parts  1  and  2  (and  Part  3,  if
applicable) completed.

Pennsylvania  Department  of  Health,  Division  of  Vital
Records Form No. HD01275F, Statement of Citizenship and
Residency.

Copy of U.S. Government Form N-560, Certificate of
Citizenship, and/or a copy of the child’s United States
passport, if either or both documents are available.

Form A-07 Rev. 07/01/22

2WHEREFORE,  Petitioner(s)  request(s)  that  this  Court  enter  a  Decree 

authorizing  the  registration  and  docketing  of  the  attached  Foreign  Adoption 

Decree with the Clerk of the appropriate Court and decreeing that  

___________________________________  shall  henceforth  be  known  as 
(Name of child as written on Foreign Adoption Decree) 

______________________________________________ and shall have all the 
(Child’s name from this time forward) 

rights of a child and heir of the Petitioner(s). 

Signature of Adopting Parent1 

Signature of Adopting Parent 

_____________________________ 
Daytime telephone no. for Adopting Parent(s) 

1 When there are two adopting parents, both must sign. 

Form A-07 Rev. 07/01/22

3VERIFICATION TO PETITION TO REGISTER FOREIGN ADOPTION DECREE 
PURSUANT TO 23 Pa. C.S. § 2908 

I/We, _________________________, verify that I/we am/are the Petitioner(s) 
named in the foregoing Petition, that I/we have read and understand the 

information set forth in the Instructions to the Petition to Register Foreign 

Adoption Decree, and that the facts set forth in the foregoing Petition are true 

and correct to the best of my/our knowledge, information and belief.  I/We further 

verify that all documents attached to this Petition are true and correct copies of 

the originals.  I/We understand that false statements made herein are subject to 

the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. 

Date: ____________________ 

Signature of Adopting Parent 

Signature of Adopting Parent 

Form A-07 Rev. 07/01/22

4