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Ent To Adopt: , CONSENT OF PARENT TO ADOPTION AND WAIVER OF NOTICE OF ADOPTION HEARING (child s current name) , (child s current name) , (child s current name) parent s name , being first duly sworn upon I, oath, depose and state as follows: 1. I was born on and reside at in the City of State of date of birth , am currently , County of years of age, street address , , . 2. I am the parent of male female check one child who was born on , State of the City of child s name.

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