B-PARENTS/SIBLINGS

REQUEST FOR
NON-IDENTIFYING INFORMATION



Sample letter Only
Your Name Your Address Your Postal Code Your Phone Number Your E-mail address Date:

Childrens Aid Society
Address of city/county where Adoption Finalized
RE: BIRTH MOTHERS NAME at time of birth, & her Birth date
Full Birthname of child
I am writing to request non-identifying background information about the couple that adopted my child/sister/brother.
Enclosed is a copy of my: a)drivers license; b)birth certificate; or c)baptismal certificate

The child was born on (full date) at (hospital if known), in the town/city of

I understand that, under the Child & Family Services Act, I am entitled to certain information about the adoptive family. I respectfully request that this information be forwarded to me, at the above address.

I would further request, that my name and information be submitted to the Adoption Disclosure Registry.
Thank you for your consideration.
Sincerely,

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