Birth Mother Affidavit Nevada Law Form

Birth Mother Affidavit Nevada Law Form - Adoption Choices of Nevada

Affidavit of Birth Mother Regarding Nevada Law Form

The Birth Mother of a child needs to understand certain information before proceeding with an adoption plan. Read the following statements carefully. Initial each line and sign below when you fully understand each statement. If you have any questions, please discuss them before you sign. You may have a copy of this document.

Affidavit of Birth Mother Regarding Nevada Law

Name of Birth Mother:(Required)

First Last Initial

Date of Birth:(Required)

1. (Please initial) Because I am the Birth Mother, I have the primary right to parent if I so choose.(Required)

2. (Please initial) There may be services and sources of financial assistance in the community which could be made available to me should I choose to exercise my right to parent.(Required)

3. (Please initial) As the Birth Mother, I may keep the child/ren regardless of any promises made between myself, the Agency and/or the Prospective Adoptive Parent(s).(Required)

4. (Please initial) I may not sign a relinquishment/consent until seventy-two (72) hours has lapsed from the birth of my child. Once I sign the relinquishment/consent, it is irrevocable. I will sign before a Notary and Agency Representative and once I sign the relinquishment/consent I cannot change my mind unless the relinquishment/consent is nullified by the court on a finding that the placement should be prohibited.(Required)

5. (Please initial) According to Nevada law I acknowledge that I understand I have the right to read the approved Home Study on the Prospective Adoptive Parent(s) that I choose, or allow the Agency to choose for me. I have the right to read the Home Study before signing the relinquishment/consent to adopt.(Required)

6. (Please initial) I acknowledge and understand that I will be relinquishing all of the rights of my child to Adoption Choices of Nevada who will then have legal custody. Nevada requires an Agency to oversee the placement for a minimum of six (6) months. When this timeframe is over, a Judge/Magistrate will transfer all custody to the Adoptive Parent(s).(Required)

7. (Please initial) I understand the child/ren cannot be placed with the Prospective Adoptive Parent(s), which I have chosen or allowed the Agency to choose, until the seventy-two (72) hours has passed after the birth of my child and I have signed the relinquishment/consent. According to Nevada law, the child may be in cradle care or with me until the seventy-two (72) hours has passed after the birth of my child and I have signed the relinquishment/consent. At that point, physical custody will transfer to the Adoptive Parent(s).(Required)

8. (Please initial) I am in full possession of my faculties and am not under the influence of any drugs, alcohol or medication that may affect my reasoning or judgment.(Required)

9. (Please initial) I am not subject to any fear, threat, menace, compulsion, or any undue influence whatsoever. I am making a plan for adoption for my child voluntarily and am making an educated decision about placement for adoption.(Required)

10. (Please initial) I understand that I will have my own legal counsel which will be provided for me by the Agency for purposes of explaining the consent and my legal rights in Nevada.(Required)

11. (Please initial) I understand that if I am unable to provide an address or any other contact information for the Birth Father, or any man identified by me as a possible father, that the Agency is legally obligated to exercise all due diligence in order to locate him and provide notice regarding the anticipated relinquishment of my child for the purpose of adoption. I further understand that should the Agency be unable to locate the Birth Father, or any other man identified by me as a possible Birth Father, for personal service of notification, that Nevada law requires the Agency to provide notice by publication in the appropriate newspaper and that this notice may contain my name as well as the child’s date of birth.(Required)

12. (Please initial) I understand that Eric Stovall is the attorney for Adoption Choices of Nevada, and does not represent me.(Required)

13. (Please initial) I have received adoption counseling from Adoption Choices of Nevada and understand my rights and responsibilities in accordance with the Laws of Nevada.(Required)

ACKNOWLEGEMENT

I understand all of the above statements. After careful consideration and of my own free will, I am making a plan of adoption possible for my child. I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and/or document and any false statements knowingly made herein may be viewed as perjury and in violation of the penal laws of my state and may subject me to criminal and/or civil penalties under the law, which may include fines and/or imprisonment.

Birth Mother Signature:(Required)

Today's Date:(Required)

Check box to acknowledge:(Required)

By submitting this form, you consent to the transmission of your information over the internet and understand the associated risks.

Affidavit of Birth Mother Regarding Nevada Law Form

Affidavit of Birth Mother Regarding Nevada Law

ACKNOWLEGEMENT

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