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The DSS 5163 form serves a critical role in the adult adoption process in North Carolina. This essential document enables individuals, whether related or not, to legally adopt an adult, ultimately establishing a parent-child relationship under the law. The form requires basic information about both the petitioning parents and the adoptee, including their names, ages, marital statuses, and addresses. It also requests details about the adoptee’s past, such as their original name as listed on their birth certificate, and the circumstances surrounding the adoption, including any existing parental relationships. The petitioners must demonstrate that they or the adoptee have resided in North Carolina for at least six months before filing, reaffirming the state's commitment to local jurisdiction in adoption matters. Additionally, the form addresses any potential financial implications or property information related to the adoptee if they were adjudicated incompetent. In essence, the DSS 5163 is not merely a procedural requirement but a significant step toward formalizing familial bonds that can have profound personal and emotional significance for all parties involved.

Dss 5163 Example

STATE OF NORTH CAROLINA

COUNTY

(Full name of petitioning parent 1)

(Full name of petitioning parent 2)

FOR THE ADOPTION OF

(Full name by which adult adoptee is to be known if adoption granted)

IN THE GENERAL COURT OF JUSTICE

DISTRICT COURT DIVISION BEFORE THE CLERK

SP

PETITION FOR

ADULT ADOPTION

To the Honorable, Clerk of the Superior Court of

 

 

____________________County:

We (1), the undersigned,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Name of petitioning parent 1)

 

 

 

 

(Sex)

(Marital Status)

and/or

 

 

 

 

 

 

 

 

 

whose address is

 

(Name of petitioning parent 2)

(Sex)

 

(Marital Status)

 

 

 

 

I

(Street & Number)

(RFD)

(City)

(County)

(State)

do hereby petition the Court for leave to adopt

(Name by which the adoptee is to be known)

, an adult, pursuant to N.C.G.S. 48-5-100, et. seq., and represent to the Court:

(Sex)

I

1.That the petitioner(s) herein seeking adoption has/have lived in or been domiciled in North Carolina for at

least six consecutive months immediately preceding the filing of this petition; or the adoptee has lived in North Carolina for at least six consecutive months immediately preceding the filing of this petition or from birth.

2.

That

 

was born in the State/Country of

(Original Name of Adult Adoptee)

on the

 

day of

I

3.That the petitioner(s) is/are [related] [not related] to the said adult adoptee in the following manner:

_________________________________________________________________________________________

4.That the following are the name, age, and last known address of any adult child of the prospective adoptive parent, including an adult previously adopted by the prospective adoptive parent or the adoptive parent's spouse, and the date and place of the adoption:

_________________________________________________________________________________________

5.That the following are the name, age, and last known address of any living parent, spouse, or adult child of adoptee:

_________________________________________________________________________________________

DSS-5163 (Rev. 11/2014)

Child Welfare Services

Page 1 of 2

6.That the following is a description and estimate of the value of any property of the adoptee, if adjudicated incompetent:

_________________________________________________________________________________________

7.That the adoptee’s true name as it appears on his/her birth certificate is:

 

_________________________________________________________________________________________

8.

That the adoptee is presently married to

 

 

 

 

, having been

 

married on or about the

____day of

__________I ____________

 

 

 

 

 

 

 

 

 

 

WHEREFORE, your petitioner(s) pray(s) that the relationship of parent and child be established between petitioner(s) and said adult and that the adult adoptee's name [remain] [be changed to]

_________________________________________________________________________________________

__________________________________________________________________pursuant to G. S. 48-9-102 (g).

This the

day of

 

I

 

 

 

 

 

 

 

 

 

___________________________________Signature of Petitioner 1

 

 

 

__________________________________ Signature of Petitioner 2

 

 

 

ACKNOWLEDGMENT

, being duly sworn, deposes and says that he/she has read the foregoing Petition and that the facts set forth therein are true to his/her knowledge, except as to matters therein set forth upon information and belief,, and as to those such matters he/she believes them to be true.

__________________________________Signature of Petitioner 1

__________________________________Signature of Petitioner 2

Subscribed and sworn to before me this

 

day of

I

(S E A L)

Clerk Superior Court or Notary Public

My commission expires:

________________________________________________________________________________________________

Attorney for petitioner/s(Mailing Address)

_________________________________________________________________________________________________

(Telephone Number)

(City or Town)

NOTE: The DSS-5163 is prepared in duplicate. The original form is held in the Office of the Clerk of Superior Court. A copy is forwarded, along with originals of all other documents filed in proceeding, within ten days following the entry of the Decree of Adoption by the Clerk of Court to the Division of Social Services, State Department of Health and Human Services.

DSS-5163 (Rev. 11/2014)

Child Welfare Services

Page 2 of 2

Form Characteristics

Fact Name Details
Governing Law The DSS 5163 form is governed by North Carolina General Statutes Chapter 48, specifically N.C.G.S. 48-5-100, et seq.
Purpose of the Form This form is used to petition for the adoption of an adult in North Carolina.
Residency Requirement Petitioners must have lived in North Carolina for at least six consecutive months before filing.
Adoptee's True Name The form requires the adoptee's true name as it appears on their birth certificate.
Property Description If the adoptee is adjudicated incompetent, a description and estimate of their property value must be included.
Form Submission A copy of the form must be sent to the Division of Social Services within ten days after the decree of adoption.

Guidelines on Utilizing Dss 5163

Completing the DSS 5163 form is an essential step in the adult adoption process. After filling out the form, you will submit it to the Clerk of the Superior Court in your county. Be prepared to provide any necessary supporting documents and pay any required fees. Follow these steps carefully to ensure that your petition is completed accurately.

  1. Begin by filling out the full names of both petitioning parents in the spaces provided at the top of the form.
  2. Indicate the County where you are filing the petition.
  3. Write the full name of the adult adoptee as they will be known if the adoption is granted.
  4. Provide your names, sexual orientation, marital status, and addresses, ensuring that all details are accurate.
  5. Confirm that at least one of the petitioners or the adoptee has lived in North Carolina for at least six consecutive months prior to filing.
  6. Enter the original name of the adult adoptee and the place of birth.
  7. Specify the relationship between the petitioners and the adult adoptee, indicating if they are related or not.
  8. List the name, age, and last known address of any adult child of the prospective adoptive parent, along with details of any previous adoptions.
  9. Provide the name, age, and last known address of any living parents, spouses, or adult children of the adoptee.
  10. Describe and estimate the value of any property that belongs to the adoptee, if applicable.
  11. Write the adoptee's true name as it appears on their birth certificate.
  12. Provide the name of the adoptee’s current spouse and the date of marriage, if applicable.
  13. State whether the adult adoptee's name will remain the same or if it will be changed, and write the new name if applicable.
  14. Sign the document at the bottom of the form for both petitioners.
  15. Finally, ensure that the form is notarized or signed in front of the Clerk of the Court as required.

What You Should Know About This Form

What is the purpose of the DSS 5163 form?

The DSS 5163 form is a petition for adult adoption in North Carolina. This legal document allows individuals to request the court's approval to establish a parent-child relationship with an adult. It outlines necessary information about the petitioners, the adoptee, and any relevant family details.

Who can use the DSS 5163 form?

The form can be used by any adult who wishes to adopt another adult in North Carolina. This may include family members or individuals with close relationships. The petitioners must also meet certain residency requirements, having lived in North Carolina for at least six months before filing.

What information do I need to provide on the form?

When completing the DSS 5163 form, you will need to provide personal information about each petitioner, details about the adoptee, and any relationships between the parties involved. This includes names, addresses, marital status, and information regarding the adoptee’s property if applicable.

Do I need to be represented by an attorney to file this form?

What happens after I file the DSS 5163 form?

After filing the form, the court will review it. A hearing may be scheduled where you can present your case. If the court approves the petition, an adoption decree will be issued. The clerk will then forward necessary documents to the Division of Social Services within ten days of the decree.

How long does the adoption process take?

The timeline for adult adoption can vary depending on several factors, including court schedules and any additional requirements. Generally, once the petition is filed, the process can take a few months from the initial filing to the court's decision.

Can I change the adoptee’s name through this process?

Yes, the DSS 5163 form allows you to request a name change for the adoptee. You will indicate whether the adoptee's name should remain the same or be changed to a new name as part of the adoption process.

Common mistakes

When filling out the DSS 5163 form, it is easy to make mistakes that could delay the adoption process. One common mistake occurs when petitioners fail to provide the full legal names of the parties involved. It is crucial to use the complete names of both petitioning parents and the adult adoptee. Incomplete or incorrect names may lead to confusion or legal issues down the line.

Another frequent error involves the residency requirement. Applicants must confirm that either the petitioners or the adoptee have lived in North Carolina for at least six consecutive months before filing. It is vital to accurately attest to this condition, as failure to do so could result in the rejection of the petition.

Additionally, many overlook the importance of detailing their relationship to the adoptee. The form explicitly asks whether the petitioners are related or not related to the adult adoptee and requires an explanation of the relationship. Leaving this section blank or providing vague details may cause the court to question the legitimacy of the adoption.

A further mistake can be found in providing information about the adoptee's existing family members. Petitioners must list the names, ages, and last known addresses of any living parents, spouses, or adult children of the adoptee. Incomplete information here can create unnecessary complications in the adoption process.

Finally, ensuring that all signatures are properly gathered is essential. Both petitioning parents need to sign the form, and their acknowledgments must be correctly sworn before a notary public. Missing signatures or improper acknowledgment can invalidate the petition, causing delays and additional paperwork.

Documents used along the form

In the process of adult adoption in North Carolina, several forms and documents complement the DSS 5163 form. Each of these documents plays a crucial role in ensuring that the adoption process is thorough and compliant with state regulations. Understanding these documents can facilitate a smoother adoption experience for all parties involved.

  • Notice of Petition for Adult Adoption: This document informs all interested parties about the intent to adopt an adult. It outlines the key details of the petition, allowing for any objections to be raised prior to the finalization of the adoption.
  • Affidavit of Consent: Obtaining consent is a vital step in the adult adoption process. This affidavit must be signed by the adult adoptee, affirming their agreement to the adoption. It may also require signatures from any relevant family members, depending on the circumstances.
  • Background Check Authorization Form: A background check may be required for all parties involved in the adoption. This form grants permission for a background investigation, ensuring that the adoptive parent is fit to take on this significant responsibility.
  • Decree of Adoption: Once the adoption has been approved, a Decree of Adoption is issued. This legal document officially recognizes the relationship between the adoptive parents and the adult adoptee, marking the completion of the adoption process.
  • Post-Adoption Contact Agreement: If applicable, this agreement outlines the expectations for contact between the adoptee and their biological family post-adoption. This document can help manage relationships and ensure clarity for all parties.
  • Home Study Report: While more common in child adoptions, a home study may be required in some adult adoptions. This report evaluates the living situation of the adoptive parents to confirm it is suitable for the adoptee.
  • Verification of Domicile: This document serves as proof of the petitioners' residency in North Carolina for the required duration. It typically includes required identification and address verification to ensure compliance with state regulations.

These documents, along with the DSS 5163 form, collectively contribute to a comprehensive approach to adult adoption, safeguarding the interests of everyone involved. Familiarity with these forms can aid prospective adoptive parents in navigating the often intricate adoption process.

Similar forms

  • Application for Adoption: Similar to the DSS 5163, this document initiates the legal process for adopting a child. Both require identification of the petitioners and the adoptee, along with a declaration of the relationship.

  • Consent to Adoption: This form must be filled out by all parties involved, indicating their agreement to proceed with the adoption. Like the DSS 5163, it ensures that all individuals recognize the adoption process.

  • Petition for Name Change: Used when an adoptee wishes to change their name post-adoption. Much like the DSS 5163, it includes personal details and the requested new name, establishing clear legal documentation.

  • Interstate Compact on the Placement of Children (ICPC) Application: This form is used when the adoption involves parties in different states. It shares similarities with the DSS 5163 as both forms ensure that relevant laws are followed.

  • Finalization Order: This document marks the official conclusion of the adoption process. Similar to DSS 5163, it contains crucial details about the adoptee and adoptive parents, confirming the establishment of a legal relationship.

  • Background Check Authorization: Required for assessing the suitability of adoptive parents. It shares procedural elements with the DSS 5163 by necessitating personal information that verifies the background of petitioners.

  • Social History Report: This report outlines personal details about adoptive parents and the adoptee's background. Like the DSS 5163, it serves to provide the court with context regarding the adoption's legitimacy.

Dos and Don'ts

When filling out the DSS 5163 form, it is important to ensure accuracy and clarity. Below is a list of recommendations to guide you through the process.

  • Do check that all names are spelled correctly, especially the names of the petitioners and the adoptee.
  • Do ensure you have lived in North Carolina for at least six consecutive months if you are petitioning for adoption.
  • Do provide complete addresses for all individuals referenced in the form.
  • Do include the correct birthdate and place of birth for the adoptee.
  • Don't leave any required fields blank; fill in every section as completely as possible.
  • Don't forget to have your signatures notarized or witnessed, as this is a legal requirement.
  • Don't submit the form without making a copy for your records.
  • Don't underestimate the importance of reviewing the completed form for errors before submission.

By following these guidelines, you can enhance the likelihood of a smooth and successful adoption process.

Misconceptions

Misconceptions about the DSS 5163 form can hinder the adoption process for many individuals. It is essential to clarify these misunderstandings to ensure that prospective adoptive parents are well-informed. Below are four common misconceptions regarding the DSS 5163 form.

  • All adoptions require a home study. Many people believe that every adoption process mandates a home study, but this is not always the case. For adult adoptions, a home study is generally not required, simplifying the process for those seeking to adopt an adult.
  • The form can only be filed by married couples. Some individuals think that only married couples can file the DSS 5163 form. In reality, single individuals are also eligible to adopt adults. The prerequisites are focused on the relationship to the adoptee, not the marital status of the petitioner.
  • The adoption process is the same for adults as for children. Many assume that adult adoption follows the same legal procedure as the adoption of minors. However, adult adoption is often less complex and involves fewer legal requirements, which can expedite the process.
  • The DSS 5163 form guarantees the adoptee’s name change. There is a belief that submitting the DSS 5163 form automatically leads to the adoptee’s name change. While the form allows for a name change, approval is ultimately at the discretion of the court, based on the submitted petition.

Key takeaways

When completing the DSS-5163 form for adult adoption in North Carolina, taking careful steps is essential. Here are key takeaways to ensure a smooth process:

  • The form must include the full names of both petitioning parents and the adult adoptee.
  • Clearly state the relationship between the petitioner(s) and the adoptee, whether related or not.
  • The petitioners must have lived in North Carolina for at least six consecutive months, or the adoptee must have resided there for the same duration.
  • Accurate information about any living parents or spouses of the adoptee must be provided.
  • Adoptive parents should include information about adult children from previous adoptions, if applicable.
  • Include a description and estimated value of any property owned by the adoptee, if the adoptee has been adjudicated incompetent.
  • Both petitioners must sign the form, acknowledging that all provided information is true to the best of their knowledge.
  • Submit one original copy of the form to the Clerk of Superior Court. The second copy will be forwarded to the Division of Social Services by the court following the adoption decree.

Being thorough and accurate on the DSS-5163 form can significantly impact the adoption process. Keep these points in mind to facilitate a successful adoption journey.