CHECK LIST FOR THE RELEASE OF CERTIFIED COPY OF AN ADOPTION ORDER

PLEASE CHECK EACH BOX AND RETURN THIS CHECK LIST WITH YOUR AFFIDAVIT.
FAILURE TO DO SO WILL RESULT IN DELAY OF YOUR REQUEST
I HAVE ENCLOSED ALL OF THE FOLLOWING

  1. ____ a cheque or money order in Canadian funds for $15.00 made payable to the
    MINISTER OF FINANCE

    ____ a notarized afidavit ____ this check list
    I am aware that:
  2. ____ the adoption order is an exact copy of the original and that it will not be altered

    or enhanced in any way,(e.g. if the order has the initial of the birth surname only, the complete birth name will not be given with the release order).
    ____ the adoption order does not include the name of the biological parent(s) or any information about them

    ____ I may be asked to provide other information to support the Registrar to decide in my favour to release this document to me.

    I am not aware of:

  3. ____ any harm that will come to any other person as a result of a copy of an Adoption Order being released to me.

    THIS SECTION SHOULD ONLY BE COMPLETED BY THE ADOPTEE

  4. _________ I was adopted by a step-parent or other birth relative.
    yes_____ no_____ don't know_______

  5. ____ I was adopted in the same family with other birth sibling(s) who is/are still under the age of eighteen years. yes____ no_____.

  6. ____ I am an adoptee already registered with the Adoption Disclosure Register and,

    (if known)my ID NO. is __________

  7. I am an adoptee not registered with the Adoption Disclosure Register and would like information about the Register yes____ no_____.

    DATE _________________ Signature____________________

    THIS SECTION SHOULD ONLY BE COMPLETED BY THOSE WHO FALL INTO "OTHER" CATEGORY ON THE AFFIDAVIT

  8. My relationship to the adoptee is ____________________

  9. Is adoptee aware of this request? yes_______ no________

  10. My reason for requesting a copy of the adoption order is
    _____________________________
    (if necessary continue on the reverse or add a separate letter)

    11. BEFORE MAILING THIS APPLICATION TO THE

    Adoption Disclosure Registry

    2 Boor Street West

    24 floor Toronto Ont.

    M7A 1E9

    PLEASE ENSURE THAT YOU HAVE:

    --SIGNED AND PROPERLY WITNESSED THE APPLICATION
    
--ENCLOSED PHOTOCOPIES OF TWO PIECES OF YOUR PERSONAL IDENTIFICATION
    
--ENCLOSED ALL PAGES OF THIS APPLICATION & CHECKLIST
    
--KEPT A COPY FOR YOUR RECORDS