Adopting from Russia - Sample Adoption Petition


While the text may not be gramatically correct, it must be exactly as your facilitator or agency instructs you, because it has to be translated into the right Russian legalese by someone with imperfect knowledge of English.

To: Yaroslavl Province Court

From: USA Citizens HusbandFirst Middle Last and WifeFirst Middle Last
City, State, Zip


We are a married couple and citizens of the United States of America, living in the state of State: HusbandFirst Middle Last born on Day Month Year and WifeFirst Middle Last born on Day Month Year. We have been married since Day Month Year.

Our reason for adoption is infertility and the desire to have both a boy and a girl. Therefore we have decided to adopt from Russia and are hereby petitioning the court with this petition to help us in adopting a child.

We are applying for adoption of Lastname Firstname Patronymic, born Day Month Year in Yaroslavl, residing in the pathology unit of Children's City Hospital #3.

We are aware that Lastname Firstname Patronymic was left by her mother in the maternity home and that data about the father was written from the mother's words. We are aware that the child does not have other siblings. We are aware of her medical conditions: Condition 1 and Condition 2.

We have no medical condition that would in any way impair our ability to adopt or to subsequently raise and care for the child.

We have permanent income and can provide the child with stable, loving, suitable living conditions and an appropriate environment for her upbringing, education and treatment if necessary.

We therefore request to:

Establish the adoption of Lastname Firstname Patronymic born on Day Month Year in Yaroslavl by us, HusbandFirst Middle Last and WifeFirst Middle Last.

To register us, HusbandFirst Middle Last and WifeFirst Middle Last, as her parents in the new birth certificate.

To change the name of the child from Firstname to NewFirstname NewMiddlename.

To exclude patronymic.

To change her last name from Lastname to NewLastname.

To leave her date of birth without change.

To leave her place of birth without change - Yaroslavl, Russia.


______________________________________ __________________________________
Adoptive Father Date Adoptive Mother Date

State of __________________
Subscribed and sworn to before me, a notary, on this __ day of ______________, 2000.

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