New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VII - Surrogate's Court Forms
Subchapter B - Adoption Forms Of The Surrogate's Court
Adoption Forms
Form 14 - Certificate of adoption

Universal Citation: 22 NY Comp Codes Rules and Regs ยง 14
Current through Register Vol. 46, No. 12, March 20, 2024

D.R.L. § 114 Form 14

(Certificate of Adoption)

12/97

SURROGATE'S COURT OF THE STATE OF NEW YORK

COUNTY OF

CERTIFICATE OF ADOPTION

I, , Clerk of the

Court of County, do hereby certify that I have inspected the records of this Court and find that:

AN ORDER OF ADOPTION was signed on the day of , 19 , by Honorable , Judge of the Court of the County of , granting the petition of (and ), adoptive parent(s) of a child now known and called by the name of , who was born at , on the day of , 19 .

This certificate as to the facts recited herein shall have the same force and effect as a certified copy of an order of adoption.

IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of the

Court of the County of

this day of , 19 .

______________

Clerk of the Court

of the County of

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