NO.

IN THE INTEREST OF § IN THE DISTRICT COURT

§
CHILD (REN’S) NAME § JUDICIAL DISTRICT
§
A CHILD § COUNTY, TEXAS

ORIGINAL PETITION FOR TERMINATION

AND ADOPTION OF STEPCHILD

1. Discovery Level

Discovery in this case is intended to be conducted under level 2 of rule 190 of the

Texas Rules of Civil Procedure.

2. Petitioners

This suit is brought by HUSBAND’S NAME

Petitioners, who is the husband to the biological mother.

Petitioner HUSBAND’S NAME is the stepfather of the child the subject of this suit.

BIOLOGCIAL MOTHER’S NAME is the mother of the child the subject of this suit and

gives consent.

3. Jurisdiction

This Court has acquired and retains continuing, exclusive jurisdiction of this suit of the

child the subject of this suit as a result of prior proceedings.

Information required by section 152.209 of the Texas Family Code is provided in the

attached affidavit, which is incorporated herein by reference.

4. Interstate Placement Information

A verified allegation or statement complying with section 162.002 of the Texas Family

Code is attached to this petition and incorporated herein by reference

A verified allegation or statement complying by section 161.103 of the Texas Family Code

is attached to this petition and incorporated for all purposes.

ORIGINAL PETITION FOR TERMINATION AND ADOPTION
HUSBAND’S NAME V. BIOLOGICAL FATHER’S NAME Page 1 of 4
 5. Child

The following child is the subject of this suit:

Name: CHILD (REN’S) NAME

Birth date: Birth date
Birthplace: Where

6. Person Entitled to Citation

The father of the child the subject of this suit is BIOLOGICAL FATHER’S NAME and

service is requested on him at BIOLOGICAL FATHER’S ADDRESS.

7. Property

No property of consequence is owned or possessed by the child who is the subject of this

suit.

8. Termination Sought

a. Father

Termination of the parent-child relationship between BIOLOGICAL FATHER’S NAME

and the child the subject of this suit is in the best interest of the child, and such termination is

requested.

As grounds for termination, Respondent agrees to voluntarily relinquish his parental

rights.

9. Ad Litems

Petitioners request the Court to appoint a guardian ad litem to represent the interests of the

child the subject of this suit.

Petitioners request the Court appoint a guardian ad litem or attorney ad litem to represent

the interests of any party entitled to the appointment of a guardian ad litem or an attorney ad litem.

ORIGINAL PETITION FOR TERMINATION AND ADOPTION

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 10. Adoption Sought

It is in the best interest of the child the subject of this suit to be adopted by HUSBAND’S

NAME, and adoption of the child is sought.

11. Residence with Petitioners

The child the subject of this suit has lived in the home of Petitioners for at least six months

when this case is heard.

12. Request for Name Change

Petitioners request that the name of the child BIRTH NAME OF CHILD be changed to

CHOSEN NAME OF CHILD.

13. Other Court of Jurisdiction

There are no other courts with jurisdiction except in the District Court of County,

Texas in case # when granted a final divorce decree between BIRTH

MOTHER’S NAME and BIRTH FATHER’S NAME.

14. Sealing of Records

Petitioners request the Court to order the sealing of the file and the minutes of the Court

after Petitioners get a certified copy of the final order.

15. Health

Petitioner stated that a Health, Social, Educational, and Genetic history report is not

required under Texas Family Code 162.005 (a) (3)

Prayer

Petitioners pray that citation and notice issue as required by law. Petitioners pray that the

Court enter its order in accordance with the allegations of this petition.

Petitioners pray for general relief.

ORIGINAL PETITION FOR TERMINATION AND ADOPTION

HUSBAND & WIFE’S NAME V. BIOLOGICAL FATHER’S NAME Page 3 of 4
 By:

ATTORNEY’S NAME OR PRO SE

Address
Phone Number

ATTORNEY FOR PETITIONERS

ORIGINAL PETITION FOR TERMINATION AND ADOPTION

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