Affirmation and Consent of Person Having Lawful Custody (Other than Birth or Legal Parent - Private Placement)
New York Family Court · Family Law
Copy of the court's form from nycourts.gov, taken October 21, 2026. See it on the court's site ↗
Affirmation and consent to a private-placement adoption in Family Court by a person, other than a birth or legal parent, who has lawful custody of the child.
This form must be printed and filled by hand, or opened in Adobe Acrobat.