H E L P I N G   P E O P L E   H E L P   T H E M S E L V E S

Legal-Eaze

International Adoption Specialists LLC

www.Legal-Eaze.com

Legal Form Preparation Without a Lawyer

International Adoption Document and Authentication Specialists

Cut and paste into your word processing program

 

Your Name

Address

Telephone Number

 

 

Date     

 

 

TO WHOM IT MAY CONCERN:

 

 

We are in the process of adopting a child from [specify which country] and hereby authorize Ms. Patti Urban, Mr. Chris P. Moore, Ms. Chandra Moore, or any other employee or agent of Legal-Eaze International Adoption Specialists LLC to obtain vital records for us, including but not limited to, birth/death/marriage/divorce certificates.

 

The vital records are to be released to the above-named authorized recipient(s) or sent directly to Legal-Eaze International Adoption Specialists LLC at either 366 Amsterdam Avenue, Suite 275, New York, NY  10024, or 290 Willow Road, Guilford, CT  06437.

 

Enclosed are photocopies of appropriate photo identifications (driver’s license or passport) for each of us.

 

If you have any questions or need any additional information, please do not hesitate to contact us.

 

Sincerely,

 

 

Husband’s Name                                                  Wife’s Name

 

 

STATE OF     _____________________)

COUNTY OF  _____________________)

 

On this                day of                                                        , 200__, before me personally appeared the within named                                                   and                                                            , to me known and known to me to be the individuals described in and who executed the foregoing and acknowledged that they executed the same.

 

____________________________________ 

Notary Public

 

LEGAL-EAZE/vital records authorization/web

 

Vital Records Authorization

Use this Sample as a Guide

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