Blank Kansas Report Of Adoption PDF Form

Blank Kansas Report Of Adoption PDF Form

The Kansas Report of Adoption form is a crucial document that officially records the adoption of a child in the state of Kansas. This form ensures that the child's new name and other vital information are accurately reflected in their amended birth record. Completing this form is essential for legal recognition of the adoption, so be sure to fill it out promptly by clicking the button below.

The Kansas Report of Adoption form, designated as FORM VS-220, serves as a crucial document in the adoption process, facilitating the amendment of a child's birth record following adoption. This form requires detailed information about the child, including their name after adoption, as well as the names and personal details of the adopting parents. Specific sections request information such as the parents' birth dates, places of birth, and social security numbers. Additionally, the form inquires whether the adoption is a step-parent, traditional, or single-parent adoption, which is essential for proper classification. It also addresses whether the child was born in a foreign country and if the adopting parents are Kansas residents. The certification section, which must be completed by a district court judge, confirms the adoption's legal status. Furthermore, the form outlines the procedures for obtaining a new birth certificate and the necessary steps for sealing the original birth records. This ensures that all information is securely managed and accessible only through court order or specific requests from the adopted individual once they reach legal age.

Document Sample

Report of Adoption

FORM VS-220 Revised 10-2021

INFORMATION FOR AMENDED BIRTH RECORD FOLLOWING ADOPTION

 

 

 

 

 

 

 

 

 

 

DO THE PARENTS WISH TO ENROLL THE CHILD IN

CHILD

1. CHILD'S NAME AFTER ADOPTION (First, Middle, Last)

 

 

 

 

 

THE IMMUNIZATION REGISTRY?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

/

 

 

 

 

 

 

 

 

Yes

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. MOTHER'S/PARENT I PRESENT NAME (First, Middle, Last)

 

 

 

2a. SEX

 

2b. LAST NAME PRIOR TO FIRST MARRIAGE

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2C. BIRTH DATE (MM/DD/YYYY)

2d. BIRTH PLACE (State)

 

 

2e. RACE

 

2f. SOCIAL SECURITY NUMBER

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2g. RESIDENCE - At the time of the child's birth: (Street and number, City, County, State, Zip )

 

 

 

Inside City Limits?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. CURRENT MAILING ADDRESS OF PARENT(S): (Street and number, City, County, State, Zip)

 

 

 

Inside City Limits?

PARENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

No

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. FATHER'S/PARENT II NAME (First, Middle, Last)

 

 

 

4a. SEX

 

4b. LAST NAME PRIOR TO FIRST MARRIAGE

FOR NEW

 

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFICATE

4c. BIRTH DATE (MM/DD/YYYY)

4d. BIRTH PLACE (State)

 

 

4e. RACE

 

4f. SOCIAL SECURITY NUMBER

/

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Was the child born in a foreign country?

Yes

No

5a. Was the child born to U.S. Citizens?

Yes

No

5b. Did the adoption occur in a foreign country?

Yes

No

5c. Are adopting parent’s Kansas residents?

Yes

No

6. TYPE OF ADOPTION (select one)

 

 

Step-Parent Adoption

 

 

 

Traditional Adoption

 

 

 

Single-Parent Adoption

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. NAME OF ATTORNEY:

 

 

 

 

 

7a. EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ATTORNEY

7b. MAILING ADDRESS OF ATTORNEY: (Street and number, City, State, Zip)

7c. TELEPHONE NUMBER + AREA CODE

 

Parent(s) Signature (I/We agree that the above information is true and correct to the best of my/our knowledge)

Parent(s)

Signature

INFORMATION FROM ORIGINAL BIRTH CERTIFICATE

8. CHILD'S NAME AT BIRTH (First, Middle, Last)

 

 

 

 

 

 

/

 

 

/

 

8a. CHILD'S BIRTH DATE (MM/DD/YYYY)

8b. CHILD'S SEX

 

 

8c. BIRTH CERTIFICATE NUMBER (if known)

/

/

 

Male

 

Female

 

9.CHILD'S BIRTH PLACE: (City, County/Province, State/Country)

10.MOTHER'S/PARENT I NAME PRIOR TO FIRST MARRIAGE (First, Middle, Last)

/

/

 

 

11. FATHER'S/PARENT II NAME (First, Middle, Last)

 

/

/

CERTIFICATION OF DISTRICT COURT

(Place court seal here)

I hereby certify that the child identified above was adopted by the above-named parent(s) on the

 

day of

 

,

 

in the District Court of

 

County, KS.

(day)

(month)

(year)

(county)

Case Number

Signature of District Court Judge

Date

Kansas Department of Health and Environment

Office of Vital Statistics

1000 SW Jackson Street, Suite 120, Topeka, Kansas 66612

INSTRUCTIONS

Please enter the information requested for each item. This is a permanent record. All information must be typed.

Kansas District Courts are required by state statute (KSA 59-2104) to report adoptions to the Office of Vital Statistics. If the child being adopted was born outside the state of Kansas, the report of adoption will be forwarded to the appropriate state vital statistics office by the Kansas Office of Vital Statistics.

This Report of Adoption and the original Certificate of Live Birth will be sealed and will be opened only by court order or by written request of the adopted person, if of legal age, as directed by KSA 65-2423.

KSA 65-2423 also authorizes, upon request, the registration of birth certificates in the state of Kansas for children born in foreign countries that are not United States citizens born abroad, but adopted by residents of Kansas or adopted in Kansas.

When a Report of Adoption is received, the Office of Vital Statistics contacts the attorney, or adoptive parents, to obtain one or both parents’ signatures on the supplemental birth certificate. At that time, we also request the filing fee to prepare and file the new birth record.

If this adoption is a step-parent adoption, natural parent information will be taken from the original birth certificate on file with the Office of Vital Statistics.

If any items are unknown, they may be left blank. However, information in items 8 through 10 is needed to locate the original certificate.

You may obtain copies of the new certificate by paying the current certified copy fee.

For information on fees, please visit our website at https://www.kdhe.ks.gov/1171/Amendments-Corrections or call (785) 296-1436.

File Specifics

Fact Name Description
Form Title The form is called the "Report of Adoption" and is designated as FORM VS-220.
Revised Date This form was last revised in October 2021.
Governing Law Adoptions are reported under Kansas Statute KSA 59-2104.
Sealing of Records The Report of Adoption and original birth certificate are sealed and can only be opened by court order or written request by the adopted person.
Residency Requirement Adopting parents must be residents of Kansas for the adoption to be processed in the state.
Fees for Copies Copies of the new birth certificate can be obtained by paying the current certified copy fee.

How to Use Kansas Report Of Adoption

Filling out the Kansas Report of Adoption form is an important step in finalizing the adoption process. After completing the form, it will be submitted to the appropriate authorities to ensure that all records are updated and accurate. Here’s how to fill it out step by step:

  1. Start by entering the child's name after adoption in the first section (First, Middle, Last).
  2. Indicate whether the parents wish to enroll the child in the immunization registry by selecting Yes or No.
  3. Fill in the mother's/parent I present name (First, Middle, Last).
  4. Provide the mother's sex and last name prior to first marriage.
  5. Enter the birth date (MM/DD/YYYY) and birth place (State).
  6. Specify the race and social security number.
  7. Provide the residence at the time of the child's birth, including street address, city, county, state, and zip code. Indicate if this address is inside city limits.
  8. Next, enter the current mailing address of parent(s) (Street and number, City, County, State, Zip) and whether it is inside city limits.
  9. Fill in the father's/parent II name (First, Middle, Last) and repeat the same steps for sex, last name prior to first marriage, birth date, birth place, race, and social security number.
  10. Answer the questions regarding the child's birth location and citizenship status by selecting Yes or No for each.
  11. Select the type of adoption from the options provided: Step-Parent Adoption, Traditional Adoption, or Single-Parent Adoption.
  12. Provide the name of the attorney, their email address, mailing address, and telephone number.
  13. In the section for information from the original birth certificate, enter the child's name at birth, birth date, sex, and birth certificate number if known.
  14. Fill in the birth place and the names of the mother and father prior to first marriage.
  15. Leave space for the certification of district court section, where the court will place their seal and signature.
  16. Finally, ensure that both parents sign the form, agreeing that the information is true and correct to the best of their knowledge.

Once you have completed the form, review it carefully for any errors or missing information. After confirming everything is accurate, submit it to the appropriate office as required. This will help facilitate the next steps in finalizing the adoption and updating the child's records.

Your Questions, Answered

What is the purpose of the Kansas Report of Adoption form?

The Kansas Report of Adoption form serves a crucial role in documenting the legal adoption of a child. This form is submitted to the Kansas Office of Vital Statistics and is essential for amending the child's birth record to reflect their new name and adoptive parents. By completing this form, adoptive parents ensure that the child's new identity is officially recognized and recorded, which is vital for legal, medical, and educational purposes.

What information is required on the form?

When filling out the Kansas Report of Adoption form, several key pieces of information must be provided. These include:

  1. The child's name after adoption.
  2. The names, birth dates, and other identifying details of the adoptive parents.
  3. Details about the child's birth, including their name at birth, birth date, and place of birth.
  4. Information regarding the type of adoption, such as step-parent or traditional adoption.

Additionally, the form requires the signatures of the adoptive parents and certification from the district court, confirming the adoption took place. It is important to ensure that all information is accurate and complete, as this is a permanent record.

How does the adoption process affect the child's original birth certificate?

Once the Kansas Report of Adoption form is submitted, the original birth certificate is sealed. This means that the details of the child's birth will not be publicly accessible without a court order or a written request from the adopted person, provided they are of legal age. The new birth certificate, which reflects the child's adoptive name and parents, will be created and registered. For children born outside of Kansas, the report will be forwarded to the appropriate state vital statistics office to ensure proper documentation.

What steps should be taken after submitting the form?

After the Kansas Report of Adoption form is submitted, the Office of Vital Statistics will contact the adoptive parents or their attorney to obtain necessary signatures for the new birth certificate. During this time, they will also request the filing fee for preparing the new record. Adoptive parents should be aware that copies of the new birth certificate can be obtained by paying the current certified copy fee. For any questions regarding fees or the process, it is advisable to visit the Kansas Department of Health and Environment's website or contact their office directly.

Common mistakes

  1. Incomplete Information: Failing to provide all required details can lead to delays. Ensure every section is filled out completely.

  2. Incorrect Names: Using incorrect spellings for names can cause complications. Double-check names for accuracy, especially for the child and parents.

  3. Missing Signatures: Forgetting to sign the form is a common oversight. Both parents must sign to validate the information provided.

  4. Wrong Dates: Entering incorrect birth dates or adoption dates can create issues. Verify all dates before submitting the form.

  5. Incorrect Attorney Information: Providing outdated or incorrect contact details for the attorney can hinder communication. Ensure this information is current.

  6. Ignoring Residency Requirements: Not clarifying the residency status of adopting parents can lead to complications. Confirm that all residency questions are answered accurately.

  7. Leaving Items Blank: While some items can be left blank, essential information should be provided. Items 8 through 10 are crucial for locating the original birth certificate.

  8. Failure to Follow Instructions: Not adhering to the specific instructions provided can result in rejection of the form. Read all instructions carefully and follow them closely.

Documents used along the form

When completing the Kansas Report of Adoption form, several other documents may be required to ensure a smooth adoption process. Each of these documents serves a specific purpose and is essential for finalizing the adoption and updating the child's records.

  • Original Birth Certificate: This document provides essential information about the child's birth, including the names of the biological parents and the child's birth details. It is crucial for verifying identity and lineage during the adoption process.
  • Adoption Decree: Issued by the court, this legal document finalizes the adoption. It includes details such as the date of adoption, the names of the adoptive parents, and the child's new legal name, if applicable.
  • Consent Forms: These forms are signed by the biological parents (if applicable) to give their consent for the adoption. They are vital for establishing that all parties involved agree to the adoption process.
  • Home Study Report: Conducted by a licensed social worker, this report assesses the adoptive parents' home environment and suitability for adoption. It is typically required for all adoptions to ensure the child's well-being.
  • Post-Adoption Contact Agreement: This document outlines any agreed-upon communication or contact between the biological and adoptive families after the adoption is finalized. It helps set expectations and maintain relationships, if desired.

Gathering these documents can be a complex process, but it is crucial for ensuring that the adoption is legally recognized and that the child's new identity is established. It is advisable to consult with a legal professional to navigate these requirements effectively.

Similar forms

The Kansas Report of Adoption form shares similarities with the Birth Certificate Amendment form. Both documents serve to update vital records following significant life events. In the case of the Birth Certificate Amendment, changes may occur due to marriage, divorce, or legal name changes. Much like the Report of Adoption, this form requires detailed information about the individual involved, including their previous and current names, birth details, and the reasons for the amendment. Both documents emphasize the importance of accurate record-keeping to reflect a person's legal status and identity.

Another document that resembles the Kansas Report of Adoption is the Certificate of Adoption. This certificate is issued after the completion of an adoption process and serves as an official record of the adoption. Like the Kansas Report, it includes essential details such as the child's new name, the adoptive parents' names, and the date of adoption. Both documents are crucial in establishing the legal relationship between the adoptive parents and the child, ensuring that the child's new identity is recognized and protected under the law.

The Petition for Adoption is another document that parallels the Kansas Report of Adoption. This petition initiates the legal process of adoption, outlining the adoptive parents' intent to adopt and providing necessary background information about the child. Similar to the Report of Adoption, it requires comprehensive details about both the child and the adoptive parents. The petition is a vital step in the adoption journey, leading to the finalization of the adoption, which is then documented in the Report of Adoption.

The Adoption Decree is also akin to the Kansas Report of Adoption. This legal document is issued by the court once the adoption is finalized, confirming the legal adoption of the child. It contains information about the child, the adoptive parents, and the court's decision. Like the Report of Adoption, the Adoption Decree serves as an official record that establishes the new legal relationship and is essential for updating the child's birth certificate and other vital records.

The Affidavit of Parentage shares similarities with the Kansas Report of Adoption in that it establishes legal parentage. This document is often used in cases where the biological parents are not married or when there is a need to clarify parental rights. Both documents require detailed personal information and serve as official records that can affect the child's legal status. They ensure that the child's rights and identities are recognized within the legal framework.

The Consent to Adopt form is another document that aligns with the Kansas Report of Adoption. This form is completed by the biological parents, giving their permission for the adoption to take place. Similar to the Report of Adoption, it requires specific information about the child and the adoptive parents. The consent is a critical part of the adoption process, ensuring that all parties involved agree to the legal transition of parentage.

The Termination of Parental Rights form is also comparable to the Kansas Report of Adoption. This document is used to legally sever the rights of biological parents, allowing for the adoption process to proceed. Both forms include detailed information about the child and the parents involved. The termination of parental rights is a necessary step in the adoption process, ensuring that the child's best interests are prioritized and that a stable, loving environment is established with the adoptive parents.

The Home Study Report is another document that has similarities with the Kansas Report of Adoption. This report is conducted by a social worker and assesses the suitability of the adoptive parents. It includes background checks, interviews, and home visits. Both documents play a crucial role in the adoption process, ensuring that the adoptive environment is safe and nurturing for the child. The Home Study Report helps provide the court with the necessary information to finalize the adoption, similar to how the Report of Adoption documents the legal outcome.

Lastly, the Adoption Placement Agreement shares characteristics with the Kansas Report of Adoption. This agreement outlines the terms and conditions under which a child will be placed with adoptive parents. Like the Report of Adoption, it includes critical information about the child and the adoptive parents. This agreement is essential in establishing a clear understanding of the responsibilities and expectations of all parties involved, ensuring that the child's transition into a new family is smooth and well-supported.

Dos and Don'ts

When filling out the Kansas Report of Adoption form, it is essential to follow specific guidelines to ensure accuracy and compliance. Here are seven things to do and not to do:

  • Do type all information clearly to avoid any confusion.
  • Do provide accurate names and dates, as these details are critical for legal records.
  • Do ensure that both parents sign the form, as their signatures are required.
  • Do include the child’s name after adoption and at birth to maintain clarity.
  • Do check if the child was born in a foreign country and answer accordingly.
  • Don't leave any mandatory fields blank; this can delay processing.
  • Don't forget to include the correct contact information for the attorney, if applicable.

Following these guidelines will help streamline the adoption process and ensure that all necessary information is provided accurately.

Misconceptions

The Kansas Report of Adoption form is a crucial document in the adoption process. However, several misconceptions exist regarding its purpose and requirements. The following list addresses these misconceptions:

  • Misconception 1: The form is only necessary for domestic adoptions.
  • This is incorrect. The form is also required for international adoptions. If a child is adopted from another country, the report must still be filed with the Kansas Office of Vital Statistics.

  • Misconception 2: Only the adopting parents need to sign the form.
  • In fact, both adopting parents must sign the form unless it is a single-parent adoption. The signatures are essential for the legal recognition of the adoption.

  • Misconception 3: The information on the form is not permanent.
  • The information provided on the Kansas Report of Adoption form becomes a permanent record. It is crucial that all details are accurate and complete, as they will be used for the child's amended birth certificate.

  • Misconception 4: The form can be submitted without a court certification.
  • This is false. The form must be certified by a district court judge to be valid. This certification verifies that the adoption has been legally finalized.

  • Misconception 5: There are no fees associated with filing the form.
  • Contrary to this belief, there is a filing fee that must be paid when submitting the form. The fee is necessary for the preparation and filing of the new birth record.

  • Misconception 6: The original birth certificate is not affected by the adoption process.
  • This is misleading. The original birth certificate will be sealed and replaced with an amended birth certificate that reflects the adoptive parents' names.

  • Misconception 7: Information can be left blank if it is unknown.
  • While some items may be left blank, essential information, particularly regarding the child's original birth details, must be provided to locate the original certificate.

Key takeaways

Filling out and using the Kansas Report of Adoption form is an important step in the adoption process. Here are key takeaways to keep in mind:

  • Accurate Information: Ensure all information is accurate and complete, as this form becomes a permanent record.
  • Typed Entries: All entries must be typed. Handwritten submissions are not acceptable.
  • Parent Signatures: Both adoptive parents must sign the form, affirming the truthfulness of the information provided.
  • Child's Name: Clearly state the child's name after adoption, including first, middle, and last names.
  • Attorney Involvement: Include the name and contact information of the attorney handling the adoption.
  • Original Birth Certificate: Information from the original birth certificate is necessary to locate it and complete the adoption process.
  • Sealing of Records: The Report of Adoption and original birth certificate will be sealed, accessible only by court order or the adopted person’s request when of legal age.
  • Filing Fee: Be prepared to pay a filing fee when submitting the form for the new birth record.
  • Foreign Adoptions: If the child was born outside the U.S., indicate this on the form, as it affects the processing of the adoption.
  • Contact Information: For any questions regarding fees or the process, reach out to the Kansas Department of Health and Environment.

By following these guidelines, you can help ensure a smoother adoption process. Take your time to fill out the form correctly, as it is a vital part of establishing the new legal identity of the adopted child.