Form 2 Dispense with Need for Consent
Form 2
QUEENSLAND
CHILDRENS COURT ACT 1992
ADOPTION ACT 2009
APPLICATION FOR AN ORDER RELATING TO CONSENT TO THE ADOPTION OF A CHILD
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The child:Name: / Date of birth:
Birth surname / Birth given names
Address:
Postal address:
Telephone:
Indigenous status: / Aboriginal but not Torres Strait Islander / Torres Strait Islander but not Aboriginal
Both Aboriginal and Torres Strait Islander / Neither Aboriginal nor Torres Strait Islander
Applicant:
Name:Surname / Given names
Address: / Facsimile:
Telephone:
Respondent:
Name: / Date of birth:
Surname / Given names / Birth place:
Address:
Postal address:
Telephone:
Relationship to child: / Birth mother: / Birth father:
Guardian:
Application Type
Application for an order dispensing with the need for the consent of the stated parent. (s35) (Please provide additional information below) (Application to dispense with the requirement to serve a copy of the application on the relevant parent. (s36))
Application for a declaration that a parent of the child has given consent.(s177)
Application to discharge a dispensation order. (s41) (Please provide additional information below
DETAILS OF COURT APPEARANCE ON FINAL PAGE
Application for an order dispensing with the need for the consent of the stated parent:
Reason for dispensation:
The applicant cannot establish the identify of the relevant parent after making all reasonable enquiries; / The Guardianship and Administration Tribunal has made a declaration that the relevant parent does not have capacity to give the consent;The applicant cannot locate the relevant parent after making all reasonable enquiries; / The relevant parent is not an adult and the relevant parent does not have capacity to give the consent;
The relevant parent is a lineal relative of the child’s mother; / The relevant parent is not in Queensland and the relevant parent does not have capacity to give the consent;
The child’s conception was a result of an offence committed by the relevant parent; / The relevant parent is not, and will not be within a time frame appropriate to the child’s age and circumstances, willing and able to protect the child from harm and meet the child’s need for long-term stable care and is unreasonably withholding his or her consent to or refusing to engage with the chief executive in relation to the issue.
There would be an unacceptable risk of harm to the child or mother if the relevant parent were made aware of the child’s birth or proposed adoption;
There are other special circumstances:
The child’s conception was a result of an offence committed by the relevant parent;
Application to discharge a dispensation order:
The ground on which the dispensation order, made under s39(1) do not apply due to:
Attachments:
Are you attaching any documents: / Yes / No
(Examples of documents you might want to attach include declarations and other Court orders) / If yes, list documents below
Signature of Applicant: / Date:
Note to the above-named Respondents:
This application will be heard in the Childrens Court at:
Court Name:
Court Address:
Date:
Time:
NOTE: If you do not attend, the Court may proceed to make an Order in your absence.
Registrar: / Date:
Form 2, Version 1 - approved 1 February 2010
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