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Petition letter sample


ADOPTION PETITION


To: Adoption Center
27 Shevchenko Blvd.
Kiev 01032, Ukraine

From: name(s) of prospective adoption parent(s)
address


We (I), the undersigned, name(s) of prospective adoption parent(s), U.S. Citizen(s), hereby request to be registered as prospective adoption parent, to be invited to the Adoption Center for selection of one or two children of any gender 4-10 years of age, and to be given a permission to visit an orphanage.

With this petition we (I) submit the following documents:
1. Copy of the U.S. passport
2. Medical certificate in due form and in compliance with Resolution 1377, Add. 4
3. Proof of income
4. Police clearance issued by the U.S. State competent authority
5. Favorable recommendation of prospective adoption parent issued by the U.S. State competent authority
6. The U.S. Citizenship and Immigration Services approval (Form I-171H)
7. Prospective adoptive parent commitment and post-adoption registration obligations


Sincerely,
name(s) of prospective adoption parent(s),

Date


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