LegalizeS.I. No. 170/1990 - Adoption Rules, 1990
This is the act as published. Later amendments are not folded into the text below: each one is a separate act in this repository and an entry in this law's history.
2 amending acts · 2010-07-14, Adoption Act 2010
| To the registered adoption society called ............................................................ ............................................... | To the registered adoption society called ............................................................ ............................................... |
| ............................................................ ............................................................ ............................................................ .. | ............................................................ ............................................................ ............................................................ .. |
| I hereby consent to the placing for adoption of the child ............................................................ ........................ | I hereby consent to the placing for adoption of the child ............................................................ ........................ |
| ............................................................ ............................................................ ............................................................ .. | ............................................................ ............................................................ ............................................................ .. |
| (here set out the name of the child) born on the ...................................... day of .............................. 19............. | (here set out the name of the child) born on the ...................................... day of .............................. 19............. |
| I say that I am/I am not the sole guardian of the said child. The father has/has not been appointed a guardian of the said child pursuant to a court order or otherwise. (a) | I say that I am/I am not the sole guardian of the said child. The father has/has not been appointed a guardian of the said child pursuant to a court order or otherwise. (a) |
| To the best of my knowledge and belief, the father has not instituted proceedings in relation to guardianship or custody of the said child. (b) | To the best of my knowledge and belief, the father has not instituted proceedings in relation to guardianship or custody of the said child. (b) |
| Here you may state your wishes as to the religion, if any, of the persons(s) with whom the said child is to be placed for adoption............................................................ ............................................................ ................................................ | Here you may state your wishes as to the religion, if any, of the persons(s) with whom the said child is to be placed for adoption............................................................ ............................................................ ................................................ |
| I have received from you a statement in Form 10. That statement was attached to this receipt and I have myself torn it off. I understand that statement. I also understand that my signature on this receipt is evidence that I have consented to the placing of the said child for adoption. | I have received from you a statement in Form 10. That statement was attached to this receipt and I have myself torn it off. I understand that statement. I also understand that my signature on this receipt is evidence that I have consented to the placing of the said child for adoption. |
| Name (in block letters) ............................................................ ............................................................ ................. | Name (in block letters) ............................................................ ............................................................ ................. |
| Signature ............................................................ ............................................................ ...................................... | Signature ............................................................ ............................................................ ...................................... |
| Address ............................................................ ............................................................ ....................................... | Address ............................................................ ............................................................ ....................................... |
| Signature of Witness ............................................................ ............................................................ ..................... | Signature of Witness ............................................................ ............................................................ ..................... |
| Address ............................................................ ............................................................ ......................................... | Address ............................................................ ............................................................ ......................................... |
| ............................................................ ............................................................ .......................................... | ............................................................ ............................................................ .......................................... |
| Occupation or Description ............................................................ ............................................................ .......... | Occupation or Description ............................................................ ............................................................ .......... |
| Date ............................................................ ............................................................ ............................................... | Date ............................................................ ............................................................ ............................................... |
| I certify that on behalf of ............................................................ ............................................................ ..................... | I certify that on behalf of ............................................................ ............................................................ ..................... |
| I have handed the statement attached to this receipt to ............................................................ ............................ | I have handed the statement attached to this receipt to ............................................................ ............................ |
| ............................................................ ........................................................... and explained its contents to her/him. | ............................................................ ........................................................... and explained its contents to her/him. |
| I am satisfied that she/he understands it. | I am satisfied that she/he understands it. |
| Signature ............................................................ ......................... | |
| Date............................................................ ................................. |
- (a) and (b) Delete words which do not apply.
Form 11.
NOTICE OF REGISTRATION OF ADOPTION SOCIETY.
(To be published by the Board in Irish Oifigiuil).
| An Bord Uchtala has registered ............................................................ ........................................ in the Adoption Societies Register. |
Form 12.
NOTICE OF CANCELLATION OF REGISTRATION OF ADOPTION SOCIETY.
(To be published by the Board in Iris Oifigiuil).
| An Bord Uchtala has cancelled the registration of ............................................................ .................................... in the Adoption Societies Register. |
Form 13.
AN BORD UCHTALA.
| In the matter of an application for an adoption order by/for |
| ............................................................ ............................................................ ............................................................ ......... |
| To: ............................................................ ............................................................ ............................................................ .. |
| ............................................................ ............................................................ ........................................... |
| In exercise of the powers conferred on it by Clause 9 of the First Schedule to the Adoption Act, 1952 , An Bord Uchtala (The Adoption Board) hereby summons you to attend before it ................................................. |
| at ............................................................ ............................................................ ........................ on the.......................... |
| day of ............................................................ .................................. 19........... at ......................................... to give evidence in relation to the above-mentioned matter. |
GIVEN under the Official Seal of the Board this .................... day of ................ 19 ............ Chairman/Registrar/a person authorised by the Board to attest the seal of the Board*.
*Delete words which do not apply.
Note: If you do not obey this Summons you are liable on summary conviction to a fine not exceeding Twenty-Five Pounds.
EXPLANATORY NOTE.
These rules prescribe forms to be used for the purposes of the Adoption Acts, 1952 to 1988. They replace similar rules made in 1976 and 1984.
The Adoption Rules 1988 ( S.I. No. 304 of 1988 ) which prescribe forms to be used for the purposes of the Adoption Act, 1988 are not affected.
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