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- Adoptee
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- Adoptive Parent
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Name of adoptee after adoption?
First
Last
Name of adoptee before adoption?
(only if different)
First
Last
Birthdate of Adoptee
Month:
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Year:
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State of birth?
Unknown
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Ohio
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Oregon
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Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
City of birth?
County of Birth?
Adoption Info
Name of adoption agency?
Name of adoption Attorney?
Date of Adoption?
Month:
Unknown
January
February
March
April
May
June
July
August
September
October
November
December
Day:
Unknown
1
2
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30
31
Year:
Unknown
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
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1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
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1931
1932
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1989
1990
1991
1992
1993
1994
1995
1996
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2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
State of Adoption?
Unknown
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
City of Adoption?
County of Adoption?
Family Information
Name of adoptive mother?
First
Last
Name of adoptive father?
First
Last
Name of birth mother?
First
Last
Name of birth father?
First
Last
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