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O. Box 4379 Harrisburg PA 17111-0379 1. 800. 227. 0225 www. adoptpakids. org CY 910 6/13 registration information ii.
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How to fill out Birth Parent/Birth Parent Survivor Authorization to Release Information and Registration Form

01
Obtain the Birth Parent/Birth Parent Survivor Authorization to Release Information and Registration Form from the relevant agency or organization.
02
Fill in the personal details of the birth parent or birth parent survivor, including full name, contact information, and any identification numbers required.
03
Provide detailed information about the child, including full name, date of birth, and any identification or case numbers.
04
Specify the purpose for which the information is being requested in the designated section of the form.
05
Sign and date the form to authorize the release of information.
06
Submit the completed form to the appropriate office or agency as instructed.

Who needs Birth Parent/Birth Parent Survivor Authorization to Release Information and Registration Form?

01
Birth parents or birth parent survivors seeking access to their child's adoption or birth records.
02
Agencies or organizations handling adoption processes or providing support services to birth parents.
03
Legal representatives or advocates assisting birth parents or survivors in obtaining information.
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The Birth Parent/Birth Parent Survivor Authorization to Release Information and Registration Form is a legal document that allows birth parents or their survivors to authorize the release of their personal information to relevant authorities or agencies, often in the context of adoption or parental rights.
Birth parents or their legal survivors are required to file the Birth Parent/Birth Parent Survivor Authorization to Release Information and Registration Form, especially when they want to ensure that their information can be shared with adopted children or relevant organizations.
To fill out the form, individuals must provide personal information such as their name, contact details, and the reason for the release of information. They may also need to provide identification details and sign the form to authorize the release.
The purpose of the form is to facilitate the legal process of sharing vital information between birth parents or their survivors and adopted individuals or organizations, ensuring transparency and maintaining connections where appropriate.
The form typically requires reporting personal information such as names, contact information, birth dates, and any relevant identifiers that can help in the identification and connection to the adopted child or pertinent parties.
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