APPLICATION FOR ADOPTION SERVICES Stepparent, Private Direct Placement, and Relative Adoptions

Small Miracles Adoption strives to provide friendly, professional services with reliable customer service and personal touch!

The legal framework for effecting adoptions in Alberta is provided by the Child, Youth & Family Enhancement Act and the Family Law Act; we are mandated to adhere to the Regulations and Legislation. The Acts define who is a guardian and who is required to sign a legal consent for adoption. If a child is 12 years of age or older, he/she is required to sign their own consent. Home Assessment Reports (HAR) are not required for this type of adoption however a Judge can order one. If your adoption is a private direct placement, the birth parents have the right to request a HAR. The report must be completed before the adoption application can be submitted to Court. The birth parents also have the right to request to see your criminal record check.

All birth parents have 10 days to revoke their consent to the adoption, after they have signed the "Consent by a Guardian for Adoption". If the revoke their consent, please contact us as soon as possible.

We strive to provide support and assistance throughout your adoption process and aim to take away the usual stresses related to the preparation and filing of an adoption. We will complete your adoption application, prepare the appropriate Affidavits, and file your adoption application with the Court of Queen's Bench on your behalf. Once the Clerk of the Courts accept your adoption application and assign a file number, we will serve Alberta Children & Youth Services (ACYS) with a copy of the adoption application; serving ACYS is a requirement in all adoptions. We can assist in serving the required biological parents as well, if you request this service.

Adoption-related expenses are income tax deductible for the tax year your adoption if finalized. The adopting person is also eligible to claim parental/adoption benefits as per Service Canada: http://www.servicecanada.gc.ca/eng/sc/ei/benefits/maternityparental.shtml

*Any official documents that are not in English must be translated by an official translator as the Court will not accept documents in other languages (all documents must be in English).*

**Please take note that it is your responsibility to provide all of the necessary documentation to Small Miracles Adoption as soon as possible in order for us to proceed with your adoption in a timely manner. **
Welcome to Small Miracles Adoption!

We are excited to begin our partnership with you. To ensure we have the information we need to best serve you, please take a few moments to fill out the form below by providing information regarding the adopting person, your spouse/partner and the child.

If you have any questions, please feel free to contact us at any time.

Thank you!
Contact Information
Adopting Person's Name

First Name Middle Name Last Name
Job Title & Place of Employment
Birthdate (mm/dd/yyy)

Month Day Year
Date
Birthplace (City/Prov)
Partner/Spouse's Name

First Name Middle Name Last Name
Job Title & Place of Employment
Birthdate (mm/dd/yyy)

Month Day Year
Date
Birthplace (City/Prov)
E-mail
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
PREFERRED CONTACT METHOD

Telehone E-mail
Marital Status

Single Married Divorced Separated CommonLaw
Biological / Birth Parents Information
Biological Mother / Guardian

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number (if different than above)

Area Code Phone Number
Biological Father / Guardian

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail
Phone Number (if different than above)

Area Code Phone Number
Court Documents
Are there any Court Orders re: custody etc?

Yes No
If yes, please provide additional information.
The Child's Information
Name at Birth

First Name Middle Name Last Name
Child's Date of Birth (m/dd/yy)

Month Day Year
Date
Child's Place of Birth
Child's Change of Name with Adoption
Additional Information
Please state the names and dates of birth of any children living in the home:
Referred to Small Miracles Adoption By:
Documents Required
Upon receipt of all required documents, you will be contacted to meet with us in person.

Marriage certificate (original or certified copy; professional translation req'd if not in English) Divorce Document (original/certified copy) Death Certificate (original/certified copy) Certified copy of permanent resident card/citizenship Certified Copy of Registration of Live Birth of Child (if born in Alberta) otherwise original birth certificate Photocopy of everyone's birth certificate and certified copy of change of name certificate Criminal Record Check of Person Adopting Child Intervention Record Check of person adopting Statement to the Court of Queen"s Bench by person adopting (see below for instructions) Statement by non-adopting parent stating relationship and history with other biological parent (to be used in your affidavit). Please be specific with dates of when you met, broke up, pregnancy information etc. Signed Contract Application fee $1000 Court File Preparation $1000 Court Package Preparation $1000 Court Filing Fee $250 Total costs approx. = $3400 with GST
STATEMENT TO THE COURTS: The person adopting is to write a heart-felt letter addressed to the Courts, "To the Justice of the Court of Queen"s Bench". The letter should describe your relationship with the child, activities, parenting, and general bonding. The letter is to be signed with printed name under signature. This must accompany the court package.
CONTRACT:

I understand in making this application that:

1) I am entering into an agreement to have Small Miracles Adoption assist us to prepare and file the court documents for this adoption.

2) I agree to pay all fees and disbursements (if any) following the completion of the work and before the adoption is finalized.

3) I understand that interest fees will apply to any outstanding amount.

4) I understand that the final paperwork will not be sent to Court if there is an outstanding balance.

5) I understand that the fees are non-refundable once the process commences.

6) By entering in my information below, I am agreeing to the above terms.
Adopting Person's Name

First Name Last Name
Date Completed

Month Day Year
Second Adopting Person's Name (if applicable)

First Name Last Name
Date Completed

Month Day Year
I am ready to submit this form. *

Yes,submit this form.
Thank You From Small Miracles Adoption.
2020.10.05
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