______Court
______County,
Tennessee / MOTION FOR PRELIMINARY ADOPTION ORDER / Case Number
______
Petitioner(s) Respondent(s)

I move the Court for an order providing that:

q The Court waives a home study of the adoptive parents by a licensed child-placing agency, a licensed clinical social worker, or the Department of Children’s Services because there is sufficient reason for the waiver, this adoption involves a relative or stepparent, and the child has not been surrendered directly to the adoptive parents.

q A guardian is appointed for the child.

q A guardian ad litem is appointed to give or withhold consent for the person sought to be adopted.

q The Court waives the appointment of a guardian for the child because there is sufficient reason for the waiver, this adoption involves a relative or stepparent, and the adoptive parents have filed the preliminary home study with the Court.

q An investigation be made of the condition and antecedents of the child sought to be adopted for the purpose of ascertaining whether the child is a proper subject for adoption, whether the proposed adoptive home is a suitable one for the child, and whether any other circumstances or conditions have a bearing on the adoption and of which the Court should have knowledge.

q The Court waives the requirement for an investigation of the condition and antecedents of the child sought to be adopted for the purpose of ascertaining whether the child is a proper subject for adoption, the proposed adoptive home is a suitable one for the child, and any other circumstances or conditions which may have a bearing on the adoption and of which the Court should have knowledge. This proceeding involves adoption by a relative or stepparent and there is sufficient reason for the waiver.

q The Court confirms the surrender of the child to ______.

q The Court confirms the parental consent to the adoption of the child.

q Other: ______

Dated:______

Signature

Telephone: ______

Fax: ______

E-Mail: ______

DATE OF HEARING ON MOTION

This motion is scheduled to be heard on ______, 20_____ at ______a.m./p.m.

CERTIFICATE OF SERVICE

I served a copy of the foregoing upon the following persons at the following addresses:

I did so on or before the date below by personal delivery or by U.S. Mail.

Dated: ______

Party Filing Motion

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