Nebraska Adoption Medical History attached hereto as Exhibit and “ ” incorporated herein by reference. Petitioners specifically allege substantial compliance with Neb. Rev. Stat. §43-104.08 through Neb. Rev. Stat. §43-104.16. [Petitioners specifically allege substantial compliance with Neb. Rev. Stat. §43-104.08 through Neb. Rev. Stat. §43-104.16, in that all procedures complied with the laws of the state of __________ which is equivalent to substantial compliance with the laws of the state of Nebraska.] No putative father has filed a Request for Notification of Intended Adoption nor a Notice of Objection to Adoption and Intent to Obtain Custody with the Nebraska Department of Social Services regarding __________________________. An Affidavit from the Department of Social Services attesting to the fact that no Request for Notification of Intended Adoption and no Notice of Objection to Adoption and Intent to Obtain Custody have been filed with the Nebraska Department of Social Services is attached as Exhibit and incorporated herein by reference. [Affidavit required even when baby “___” born out of state or when birthfather signs Relinquishment.] ___________________________ and __________________________ were [divorced] [parties to a paternity proceeding] on ________________, 20___, in ____________ County, Nebraska. [A Motion to Consent to Adoption and for determination of birthfather’s consent pursuant to Neb. Rev. Stat. § 43-104.22 and § 43-104.25, has been filed with the ___________ County District Court, as
Nebraska Adoption Medical History attached hereto as Exhibit “ ” and incorporated herein by reference. Petitioners specifically allege substantial compliance with Neb. Rev. Stat. §43-104.08 through Neb. Rev. Stat. §43-104.16. [Petitioners specifically allege substantial compliance with Neb. Rev. Stat. §43-104.08 through Neb. Rev. Stat. §43-104.16, in that all procedures complied with the laws of the state of __________ which is equivalent to substantial compliance with the laws of the state of Nebraska.] No putative father has filed a Request for Notification of Intended Adoption nor a Notice of Objection to Adoption and Intent to Obtain Custody with the Nebraska Department of Social Services regarding __________________________. An Affidavit from the Department of Social Services attesting to the fact that no Request for Notification of Intended Adoption and no Notice of Objection to Adoption and Intent to Obtain Custody have been filed with the Nebraska Department of Social Services is attached as Exhibit “___” and incorporated herein by reference. [Affidavit required even when baby born out of state or when birthfather signs Relinquishment.] ___________________________ and __________________________ were [divorced] [parties to a paternity proceeding] on ________________, 20___, in ____________ County, Nebraska. [A Motion to Consent to Adoption and for determination of birthfather’s consent pursuant to Neb. Rev. Stat. § 43-104.22 and § 43-104.25, has been filed with the ___________ County District Court, as
2017AM_Family.docx