Adoption Of Children Regulations 1994 (NT)
NORTHERN TERRITORY OF AUSTRALIA
ADOPTION OF CHILDREN REGULATIONS 1994
As in force at 20 June 2018
northern territory of australia
As in force at 20 June 2018
ADOPTION OF CHILDREN regulations 1994
Regulations under the Adoption of Children Act 1994
These Regulations may be cited as the
These Regulations shall come into operation on the commencement of the
(1) In these Regulations, unless the contrary intention appears,
adopted person means a person in respect of whom an order for adoption has been made (whether made before or after the commencement of the Act) under a law in force in the Territory.(2) A reference in these Regulations to a form by number is a reference to the form so numbered in the Schedule.
(3) If, in these Regulations, the Registrar of Births, Deaths and Marriages is required to sign the Registrar’s name or add the date in relation to the making of an entry, or a notation in respect of an entry, in a register and the register is kept by electronic means, it is sufficient compliance with that requirement if the Registrar of Births, Deaths and Marriages enters identifying symbols equivalent to the Registrar’s signature and to the date.
(1) An application by a person alone or a couple under section 17(1) of the Act (including the persons referred to in section 19 of the Act as applying to have their names included on the adoption list) shall be in accordance with Form 1.
(2) The Minister may require that a person who makes an application for the purposes of adopting a child under section 17(1), in support of the application:
(a) provides to the Minister:
(i) a medical report in a form approved by the Minister;
(ii) written authorization for the Minister to obtain a criminal history report in respect of the person from the Police Force of the Northern Territory of Australia; or
(iii) written authorization for the release of medical information to the Minister; or
(b) undergoes a medical examination by a medical practitioner approved by the Minister for that purpose.
5 Information to be given to person consenting For the purposes of section 30(2) of the Act, the information in respect of the effect of an order for adoption and the alternatives to adoption must be in accordance with Form 2.
(1) A consent to the adoption of a child shall be in accordance with Form 3.
(2) A person consenting to the adoption of a child shall sign and date the instrument of consent, or shall acknowledge signing and dating the instrument of consent, in the presence of 2 witnesses who shall be:
(a) a commissioner for oaths, a justice of the peace, a lawyer (other than a lawyer acting for the person consenting to the adoption) or a public notary; and
(b) an approved person (except that person shall not be the approved person who counselled the person consenting to the adoption in accordance with section 30(1) of the Act).
(3) The witnesses referred to in subregulation (2) shall each attest and subscribe the instrument of consent in the presence of the person consenting to the adoption, but a form of attestation is not necessary.
(1) A parent of a child who intends to relinquish a child for adoption may, in accordance with Form 4, record the parent’s wishes in respect of the following:
(a) the suitability of a person or persons to adopt the child;
(b) arrangements with the adoptive parent or parents in respect of access to the child or the giving and receiving of information about the child;
(c) the receipt of notice of the making of an application for an order for the adoption of the child in order to determine whether or not the parent wishes to be a party to the adoption proceedings.
(2) A parent who records the parent’s wishes in accordance with Form 4 may vary, amend or revoke that instrument:
(a) in respect of a matter mentioned in subregulation (1)(a) or (b), at any time while the child is not allocated to a person or persons wishing to adopt the child; or
(b) in respect of a matter mentioned in subregulation (1)(c), at any time before an application for an order for adoption is made to the Court.
8 Prescribed forms for order for adoption, order discharging order for adoption and certificate issued by Minister (1) A memorandum referred to in section 54(1) of the Act for an order for adoption must be in accordance with Form 5.
(2) A memorandum referred to in section 54(1) of the Act for an order discharging an order for adoption must be in accordance with Form 5.
(3) A certificate referred to in section 55(2) of the Act must be in accordance with Form 6.
(1) This regulation applies if any of the following (an
adoption document ) for a child is received by the Registrar:(a) a memorandum or certificate referred to in regulation 8(1), (2) or (3);
(b) a copy of an order made under section 52 of the Act;
(c) a document forwarded to the Registrar under section 54(2) of the Act;
(d) a memorandum or copy of an order referred to in section 57 of the Act.
(2) The Registrar must register the adoption document by entering particulars about the child and parents of the child in the Register of Adoptions:
(a) on the basis of the particulars (including incomplete particulars) in the adoption document and any order to which the document relates; and
(b) as the Registrar considers appropriate in the circumstances.
(3) The following must not be open for public inspection:
(a) the Register of Adoptions;
(b) any of the following received by the Registrar:
(i) an adoption document;
(ii) a copy of an order to which an adoption document relates.
(4) Subject to regulation 10, the Registrar must not issue a copy of, or an extract from, an entry in the Register of Adoptions or a document referred to in subregulation (3)(b), unless:
(a) a court orders the Registrar to do so; or
(b) both of the following apply:
(i) the Minister has, under Part 6 of the Act, provided information associated with the entry or document;
(ii) the copy or extract contains only information that may be provided under that Part; or
(c) both of the following apply:
(i) the Registrar is satisfied that the copy or extract is required for court proceedings;
(ii) the issuing of the copy or extract is approved by the Minister.
(5) The Registrar must ensure the information in the Register of Adoptions may be searched by reference to a name or other identifying information.
(6) In this regulation:
Registrar means the Registrar of Births, Deaths and Marriages.
(1) A person may, in respect of an adopted person, make application in writing to the Registrar of Births, Deaths and Marriages for the issue of a certificate stating particulars, as they appear from an entry in the Register of Adoptions, of either of the following:
(a) the date and place of birth of the adopted person;
(b) the name or names of the adoptive parent or adoptive parents, as the case may be, of the adopted person.
(2) The Registrar of Births, Deaths and Marriages must not accept an application under subregulation (1) unless it specifies:
(a) sufficient particulars in respect of the entry referred to in that subregulation which enable the Registrar of Births, Deaths and Marriages to identify the relevant entry; and
(b) except where the application is made by the person to whom the entry relates, the reason for which the certificate is required.
(3) Subject to this regulation, the Registrar of Births, Deaths and Marriages must, on receipt of an application duly made under subregulation (1) and the prescribed fee under the
Births, Deaths and Marriages Registration Act 1996 :(a) search for the relevant entry in the Register of Adoptions; and
(b) issue to the person making the application a certificate which states the name of the person to whom the entry relates, the date and place of birth of that person and the name or names of the adoptive parent or adoptive parents of that person.
(4) If an application for the issue of a certificate under this regulation is made by a person other than the person to whom the relevant entry in the Register of Adoptions relates, the Registrar of Births, Deaths and Marriages may refuse to issue the certificate if the Registrar is of the opinion that the person making the application has not a proper reason for requiring the issue of the certificate.
(1) This regulation applies only to a child:
(a) who was born in the Territory or an overseas country and in relation to whom:
(i) an order for the adoption of the child under Part 3 of the Act has been made; or
(ii) an order for the discharge of an order referred in subparagraph (i) has been made; or
(b) who was born in an overseas country and in relation to whom all of the following conditions are satisfied:
(i) under Part 4 of the Act, the adoption of the child is taken to have the same effect as an order for adoption made under the Act;
(ii) the birth of the child is not registered under a corresponding law within the meaning of the
Births, Deaths and Marriages Registration Act 1996 ;(iii) at least one of the adoptive parents of the child is a resident of the Territory and has been residing in the Territory for a continuous period of at least 6 months;
(iv) the child is a resident of the Territory.
(2) If the Registrar registers the adoption of a child and the birth of the child is not registered in the Register of Births, the Registrar must:
(a) register the birth of the child in the Register of Births; and
(b) include in the entry under paragraph (a) a notation stating the birth of the child is registered under this subregulation.
(3) If the Registrar registers the adoption of a child and the birth of the child is registered in the Register of Births, the Registrar must:
(a) re-register the birth of the child in the Register of Births; and
(b) include in the entry under paragraph (a) a notation stating the entry is made under this subregulation; and
(c) include in the previous entry made for the child in the Register a notation stating:
(i) the previous entry is no longer current; and
(ii) the birth of the child is re-registered under this subregulation.
(4) If the Registrar registers the discharge of an order for the adoption of a child and the birth of the child was registered in the Register of Births before the order for the adoption was made, the Registrar must:
(a) subject to any contrary direction in the order for the discharge – revive the entry for the child in the Register that was current immediately before the order for the adoption was made; and
(b) include in the entry referred to in paragraph (a) a notation stating:
(i) the order for the adoption has been discharged; and
(ii) other entries in the Register for the child are no longer current; and
(c) include in each of the other entries referred to in subparagraph (b)(ii) a notation stating:
(i) the order for the adoption has been discharged; and
(ii) the entry is no longer current (to the extent to which such a notation has not been included).
(5) If the Registrar registers the discharge of an order for the adoption of a child and the birth of the child was not registered in the Register of Births before the order for the adoption was made, the Registrar must include in the current entry in the Register for the child a notation stating:
(a) the order for the adoption has been discharged; and
(b) the entry is no longer current.
(6) The Registrar must register or re-register the birth of a child by entering particulars about the child and parents of the child in the Register of Births:
(a) on the basis of the particulars (including incomplete particulars) in the adoption document referred to regulation 9(1) and any order to which the adoption document relates; and
(b) as the Registrar considers appropriate in the circumstances.
(7) Subject to regulation 3(3), a notation referred to in subregulation (2), (3), (4) or (5) must be signed and dated by the Registrar.
(8) The notation must not be included in a copy of, or extract from, an entry in the Register of Births issued by the Registrar.
(9) A registration or re-registration under this regulation has effect as if it were a registration made for section 13 of the Births, Deaths and Marriages Registration Act.
Note for subregulation (9) Accordingly, a certificate may be issued by the Registrar in relation to an entry about the child under the Births, Deaths and Marriages Registration Act 1996. (10) For this regulation:
(a) a reference to the registration of the adoption of a child is a reference to the registration under regulation 9 of a document referred to in regulation 9(1) (other than a document about the discharge of an order for adoption) for the child; and
(b) a reference to the registration of the discharge of an order for the adoption of a child is a reference to the registration under regulation 9 of a document referred to in regulation 9(1) about the discharge of an order for the adoption of the child.
(11) In this regulation:
Registrar means the Registrar of Births, Deaths and Marriages.
A memorandum of an order for the adoption of a child, or an order discharging such an order, whose birth the registrar has reason to believe is registered in a State or in another Territory of the Commonwealth shall be in accordance with Form 5.
(1) If the Registrar of Births, Deaths and Marriages is satisfied that the Register of Adoptions contains an error or misstatement in, or an omission from, any particulars entered in it under these Regulations, the Registrar may correct the Register of Adoptions by causing the true particulars or the particulars omitted from the Register of Adoptions, as the case may be, to be entered in the Register of Adoptions in association with the entry to which those last-mentioned particulars relate.
(2) If the Registrar of Births, Deaths and Marriages makes a correction in the Register of Adoptions under subregulation (1), the Registrar must sign the Registrar’s name immediately under the correction and write the date on which the correction was made.
(1) If the Registrar of Births, Deaths and Marriages is satisfied that an entry in the Register of Adoptions is false, the Registrar may cancel the entry by entering in association with the entry the words "Cancelled under regulation 14 of the
Adoption of Children Regulations 1994 ”, signing the Registrar’s name immediately under those words and adding the date on which the entry was cancelled.(2) The Registrar of Births, Deaths and Marriages may not cancel an entry in the Register of Adoptions if any error or misstatement in, or omission from, the Register of Adoptions can be corrected under regulation 13.
A person shall not:
(a) destroy, deface or damage the Register of Adoptions; or
(b) obtain the registration or re-registration of the birth of an adopted child otherwise than in accordance with these Regulations.
Maximum penalty: 40 penalty units.
(1) For the purposes of section 65(2) of the Act, a notice of prohibition shall be in accordance with Form 7.
(2) A person who lodges a notice of prohibition with the Minister may, at any time, revoke the notice of prohibition by notice in writing served on the Minister.
(3) Service of the notice of revocation on the Minister under subregulation (2) shall be effected by delivering it personally, or by sending it by certified mail, to the appropriate office within the Department.
(4) On being served the notice of revocation in accordance with subregulation (3), the Minister shall, as soon as practicable, cause a record of the details of the notice of revocation and its receipt to be made and thereupon the notice of revocation shall take effect.
(1) These Regulations as amended by the
Adoption of Children Amendment Act 2006 apply to an adoption made before, on or after the commencement of that Act.(2) However, they apply to a child for whom a registration was made in the Register of Adoptions before the commencement of that Act with the following modifications:
(a) regulation 11(1)(b)(iii) and (iv) are taken to be omitted;
(b) if the last entry for the registration was made on or after 3 May 1994 – the Registrar is not required to do anything under regulation 11 for the child unless an application for it is made to the Registrar;
(c) if the last entry for the registration was made before 3 May 1994 – the Registrar is not required to do anything under regulation 11 for the child unless:
(i) an application for it is made to the Registrar; and
(ii) the Registrar considers it is appropriate in the circumstances.
(3) In this regulation:
Registrar means the Registrar of Births, Deaths and Marriages.
FORM 1
regulation 4
NORTHERN TERRITORY OF AUSTRALIA
section 38
ADOPTION APPLICATION
Please return to
Adoption Unit
Territory Families
PO Box 37037
WINNELLIE NT 0820
Full Names of Applicant(s) (Please PRINT)
...............................................................…………………………………………
Phone Work: .............…… Home: …................
Postal Address: ...............................................…………………………………..
______________________________________________________________I/we apply to the Minister to be approved as suitable persons to adopt a child/children.
I/we understand that being approved as suitable to adopt a child does not ensure that a child will be placed with me/us for adoption.
Applicant’s signature: ...........………………............
Applicant’s signature: .......................………………
...../...../....
______________________________________________________________INFORMATION REQUIRED FROM PERSONS SEEKING APPROVAL AS SUITABLE TO ADOPT A CHILD/CHILDREN
The information you provide is designed to assist in the assessment of your suitability to adopt a child. It also includes some of the matters the Court will consider if you make an application to the Court to adopt a child.
Information about your religion, race or ethnic background is relevant as the wishes of a birth parent must be taken into account before placing a child with you.
Information provided must be correct at the time you sign the form, however it is understood your circumstances may change to some extent.
If any question does not apply to you, please write "NA" in the answer space.
PROPOSED ADOPTIVE PARENTS
Parent 1
Surname .......................................................…..
Given Names .....................................................
If surname has changed since birth, previous surnames (s)
Parent 2
Surname .......................................................…..
Given Names .....................................................
If surname has changed since birth, previous surnames (s)
Date and Place of Birth ...../...../.... ...../...../....
................………………………………….................
Occupation and Employer ............…..……………………………......….............
………………………………………………..…………..............…........…............
If married or in a traditional Aboriginal marriage:
Date and Place of Marriage/traditional Aboriginal marriage
...../...../.... .......................………………………………………………………
If in a de facto relationship:
Date of commencement of relationship ...../...../....
Residential address (if not same as postal address)
.........................................................……………..…………………………………
Family religion .......................…………………………………………………….
Race or Ethnic origin .......................………………………………………………
………………………………………………………......................………………
Date of citizenship/naturalisation ...../...../....
....../...../....
Children of the above marriage/traditional Aboriginal marriage/de facto relationship
NAME DOB SEX STATUS
.....................................………………………………………….............................
..............................................................……………………………………………
STATUS
Natural N
Adopted A
Fostered F
Previous Marriages/traditional Aboriginal marriages/de facto relationships
1. Divorce date and Number
...../...../.... ...../...../....
2. Death of Spouse – date
...../...../.... ...../...../....
3. Separation date (de facto relationships only)
...../...../....
...../...../....
Children of previous marriage/traditional Aboriginal marriage, living with you/de facto relationship
NAME DOB SEX STATUS
....................................……………………………………………..........................
.................................................…………………………………………….............
STATUS
Natural N
Adopted A
Fostered F
Other residents in your home .................................……………………………..
Are you able to have children? ................................…………………………….
Applicant’s physical description ..............................…………………………….
Education History (Schools, approx. dates attended)
.............................................................……………..………………………………
...............................................................……………………………………………
Employment History (occupations, dates) Attach extra pages if necessary
......................................................………………....……………………………….
............................................................………………..…………………………….
Interests/Activities ..........................................……………………………………..
Community Involvement .........................................…………………………….
______________________________________________________________FINANCIAL SITUATION
Salary (gross weekly) .......................................…………………………….…...
Other Income eg Rent, Maintenance, Interest
..................………………………………….………………...............……………
Bank Accounts and Overdrafts (details and approx. balance)
..................……………………………………...……………………….................
Assets (other properties, vehicles etc and values)
..................…………………………………….........………………………...........
Liabilities Commitments, hire purchase, loans, mortgage, details of monthly payments and length of debt.)
..................……………………………………...…………………….....................
.................... TOTAL Annual Income ....................
TOTAL Annual Expenses .................... ....................
______________________________________________________________Details of child you wish to adopt
Please tick one box
Local Overseas
Preferred sex (if any): ......................…………
Age range: .......….. Maximum age: ........….
Preferred ethnicity: .......................………………………………………………...
Would you consider a child with a minor physical disability?
Yes No
Would you consider a child with an intellectual disability?
Yes No
Would you consider siblings?
Yes No
Have you previously been refused an adoption applicant?
Yes No Yes No
If ‘yes’, where? ................................................
Do you have a current adoption application with another agency?
Yes No
If "yes", where? ................................................
______________________________________________________________REFERENCES
Please give details of two referees, excluding relatives.
Name: 1. ....................................................…………………….………………
Occupation: ..............................................…….……………….….………………
Address: .................................................……………..……..………………...
Name: 2. ....................................................……………………………………
Occupation: ..............................................……………………….……………….
Address: .................................................……………………………………...
______________________________________________________________
I hereby declare that the particulars show herein are true and correct
.......................……………… ………………….........................
Signature Signature
...../...../.... ...../...../....
______________________________________________________________Note
You may be required to:
(a) provide:
1. a medical report
2. written authorisation for Minister to obtain a criminal history check
3. written authorisation for the release of medical information to the Minister
(b) undergo a medical examination by a medical practitioner of the Minister’s choice
FORM 2
regulation 5
NORTHERN TERRITORY OF AUSTRALIA
section 30(2)
PRESCRIBED INFORMATION FOR PERSON CONSENTING TO ADOPTION
THE EFFECT OF AN ORDER FOR ADOPTION
On the making of an order for the adoption of a child:
(a) the child becomes, for all purposes and as regards all relationships (but subject to Division 7 of Part 3 of the Act and any other law in force in the Northern Territory that expressly distinguishes between birth children and adopted children), the child of the adoptive parent or parents;
(b) existing relationships in respect of the child cease to have effect except for the purpose of determining relationships relevant to an illegal marriage or the commission of a sexual offence;
(c) an existing appointment as guardian ceases to have effect;
(d) a previous adoption of the child ceases to have effect;
(e) an order as to parentage or a maintenance order (except as to arrears owing) ceases to have effect;
(f) rights in respect of property and succession to property are, subject to express provision otherwise, determined according to the relationship created by the adoption but property rights acquired before the adoption are not affected;
(g) the child acquires the domicile of the adoptive parent, but the race, nationality and citizenship of the child are not affected.
THE ALTERNATIVES TO ADOPTION
The alternatives to relinquishing a child for adoption are:
(a) the temporary placement of the child with relatives or friends until the parent or parents are able to care for the child. The parent or parents would remain the guardian(s) of the child and be responsible for the long term welfare of the child and make the decisions regarding the child’s health, education and religious upbringing. The relatives or friends would have responsibility for the daily care and control of the child including (as agreed) making decisions regarding accommodation, clothing, feeding, behaviour and urgent or routine health needs;
(b) a temporary placement arrangement under section 46 of the
Care and Protection of Children Act 2007 ;(c) the making of a formal guardianship or custody order under the
Family Law Act in favour of relatives or friends where the parent or parents consider(s) that will not be able to care for the child for a long period of time. The parent or parents may apply to have the orders varied when they wish to assume responsibility for the child.
FORM 3
regulation 6
NORTHERN TERRITORY OF AUSTRALIA
section 31
CONSENT OF ADOPTION
I, (1)
of (2)
as (3)
hereby consent to the adoption of (4)
who was born on (5) at (6)
*by any person or persons who the Minister, or the Minister’s delegate, is satisfied is suitable to adopt (4)
*by (7)
(1)
consented to the adoption of (4)
after I provided, as required by section 30 of the Act:
(a) counselling; and
(b) the information in the prescribed form on (10)……….
.......................………. ....................
Signature Date
______________________________________________________________NOTES
(1) Name of person consenting to the adoption.
(2) Address of person consenting to the adoption.
(3) Specify capacity in which consenting, eg: parent or guardian.
(4) Name of child to be adopted as appears in Birth Register.
(5) Date of birth of child to be adopted.
(6) Place of birth of child.
(7) Full name(s) and address(es) of person(s) to adopt the child where one is a relative of the child or the spouse of a relative of the child, or where the Minister as the child’s guardian will consent to the adoption.
(8) Name of approved person who counselled person consenting to the adoption.
(9) Address of the approved person.
(10) Date information given to persons consenting
FORM 4
regulation 7
NORTHERN TERRITORY OF AUSTRALIA
section
STATEMENT BY RELINQUISHING PARENT IN RESPECT OF ADOPTION
* I have received advice and counselling concerning the adoption of my child and am aware that I may participate in the selection of the adoptive parents of my child and be advised when the application for an order for adoption of my child is to be made and that I may be a party to the adoption proceedings.
* I do/do not wish to participate in the selection of the adoptive parents of my child.
* I do/do not wish to be advised of the making of the application for an order for adoption and the date and time of the hearing of the application.
* I do/do not wish that my child be placed with, and brought up by, a family that has the same ethnic and cultural origins as I do.
* I do wish that my child be brought up in the religion.
* I do/do not wish to have access to my child and/or receive information about my child after my child has been adopted. I am aware that such arrangements can only be made and continue in force while complied with by myself and the adoptive parent(s). I am also aware of the counselling and mediation facility provided under the Act should a dispute arise between myself and the adoptive parent(s) in respect of the arrangements.
* I am aware that I may amend vary or revoke this statement before the allocation of my child to persons wishing to adopt my child concerning matters relating to the selection of the adoptive parents and otherwise at anytime.
.......................………………...
Signature Date
* Delete where appropriate.
FORM 5
regulations 8 and 12
NORTHERN TERRITORY OF AUSTRALIA
sections 54(1)
and 56(2)
MEMORANDUM OF ORDER
No.
In the Local Court of the Northern Territory of Australia at
Order
Date of order
Full name of child before adoption
Sex of child
Date and time of birth
Place of birth
Whether the child’s birth is a multiple birth and if so, the numerical order in which the child was born
Weight of child at birth
Birth parent 1’s full name at date of adoption
Birth parent 1’s previous surname(s)
Birth parent 2’s full name at date of adoption
Birth parent 2’s previous surname(s)
Full name of child after adoption
Adoptive parent 1:
full name
previous surname(s)
occupation
usual place of residence
date of birth
place of birth
age at date of birth of adopted child
if the adoptive parent has had other children – the full name, sex and date of birth of each of them (including adopted children and deceased children) and whether the child arose from a current relationship
Adoptive parent 2:
full name
previous surname(s)
occupation
usual place of residence
date of birth
place of birth
age at date of birth of adopted child
if the adoptive parent has had other children – the full name, sex and date of birth of each of them (including adopted children and deceased children) and whether the child arose from a current relationship
Whether or not the child or a birth parent or adoptive parent of the child is of Australian Aboriginal or Torres Strait Islander origin
Whether the adoptive parents of the child are residents of the Territory and have been residing in the Territory for a continuous period of at least 6 months
Whether or not the child is a resident of the Territory
Whether the birth of the child has been registered in the Register of Births of a State or another Territory
If the adoptive parents of the child are married or in a traditional Aboriginal marriage, place and date of marriage or traditional Aboriginal marriage
If the adoptive parents of the child are in a de facto relationship, the date of commencement of the relationship
Full name, sex and date of birth of each of the other children (including adopted children and deceased children) arising from the relationship between the adoptive parents of the child
Full name, sex and date of birth of each of the other adopted children (including deceased children) of the adoptive parent of the child if the child only has one adoptive parent
Full name, occupation, usual place of residence and relationship (if any) to the child, of the person furnishing the particulars in this form
Full name of the doctor, midwife or health worker responsible for the professional care of the birth parent who gave birth to the child at the birth, and other persons present at the birth
Dated
REGISTRAR
FORM 6
regulation 8
NORTHERN TERRITORY OF AUSTRALIA
section 55(2)
CERTIFICATE OF MINISTER
I, (1), the Minister responsible for the administration of the
Dated
MINISTER
NOTES
(1) Name of Minister
(2) Full name of child the subject of the certificate
(3) Date of birth of child
(4) Full name of adoptive parent(s) of child
(5) Address of adoptive parent(s) of child
(6) Date of adoption
(7) Country of adoption
SCHEDULE
Full name of child before adoption
Sex of child
Date and time of birth
Place of birth
Whether the child’s birth is a multiple birth and if so, the numerical order in which the child was born
Weight of child at birth
Birth parent 1’s full name at date of adoption
Birth parent 1’s previous surname(s)
Birth parent 2’s full name at date of adoption
Birth parent 2’s previous surname(s)
Full name of child after adoption
Adoptive parent 1:
full name
previous surname(s)
occupation
usual place of residence
date of birth
place of birth
age at date of birth of adopted child
if the adoptive parent has had other children – the full name, sex and date of birth of each of them (including adopted children and deceased children) and whether the child arose from a current relationship
Adoptive parent 2:
full name
previous surname(s)
occupation
usual place of residence
date of birth
place of birth
age at date of birth of adopted child
if the adoptive parent has had other children – the full name, sex and date of birth of each of them (including adopted children and deceased children) and whether the child arose from a current relationship
Whether or not the child or a birth parent or adoptive parent of the child is of Australian Aboriginal or Torres Strait Islander origin
Whether the adoptive parents of the child are residents of the Territory and have been residing in the Territory for a continuous period of at least 6 months
Whether or not the child is a resident of the Territory
Whether the birth of the child has been registered in the Register of Births of a State or another Territory
If the adoptive parents of the child are married or in a traditional Aboriginal marriage, place and date of marriage or traditional Aboriginal marriage
If the adoptive parents of the child are in a de facto relationship, the date of commencement of the relationship
Full name, sex and date of birth of each of the other children (including adopted children and deceased children) arising from the relationship between the adoptive parents of the child
Full name, sex and date of birth of each of the other adopted children (including deceased children) of the adoptive parent of the child if the child only has one adoptive parent
Full name, occupation, usual place of residence and relationship (if any) to the child, of the person furnishing the particulars in this form
Full name of the doctor, midwife or health worker responsible for the professional care of the birth parent who gave birth to the child at the birth, and other persons present at the birth
FORM 7
regulation 16
NORTHERN TERRITORY OF AUSTRALIA
section 65(2)
NOTICE OF PROHIBITION
THIS FORM IS TO BE USED BY AN ADOPTED PERSON OR A RELINQUISHING PARENT WHO WISHES TO DISALLOW THE RELEASE OF INFORMATION IN RESPECT OF AN ADOPTION WHICH TOOK PLACE BEFORE 3 MAY 1994 WHICH WOULD IDENTIFY THE PERSON OR PARENT.
PLEASE PROVIDE AS MUCH INFORMATION AS YOU ARE ABLE TO AS THIS WILL ASSIST US IN QUICKLY LOCATING YOUR RECORDS.
SECTION A – To be completed by all persons intending to lodge a notice of prohibition
CURRENT SURNAME
GIVEN NAMES DOB SEX
CURRENT ADDRESS
POSTCODE
TELEPHONE (HOME) (WORK)
ARE YOU (Please Tick Appropriate Box)
an adopted person a relinquishing parent
______________________________________________________________SECTION B (to be completed by adopted person)
YOUR ADOPTIVE PARENTS NAMES
PARENT 1 PARENT 2
ADOPTIVE PARENTS ADDRESS AT TIME OF ADOPTION (if unknown – please indicate "unknown")
______________________________________________________________SECTION C (to be completed by relinquishing parent)
RELINQUISHING PARENT/S FULL NAME/S AT THE TIME THE CHILD WAS RELINQUISHED FOR ADOPTION:
PARENT 1.................... PARENT 2....................
(if recorded at time of birth)
ADDRESS AT THAT TIME
IF THE CHILD WAS NAMED AT BIRTH, WHAT WAS THAT NAME
DATE OF BIRTH OF CHILD
PLACE OF BIRTH OF CHILD
______________________________________________________________SECTION D (to be completed by all persons intending to lodge a notice of prohibition)
TO THE MINISTER
I wish to lodge a notice of prohibition under section 65(2) of the
I disallow the provision of information in respect of the adoption details of which I have specified above.
I disallow the provision of information that would identify me, being my name and last-known address and any other information kept under the Act which might enable a person to ascertain my identity and/or whereabouts.
I wish this notice of prohibition to remain in force from (1)
to (2)
I understand the following in relation to the notice of prohibition:
– The notice of prohibition will remain in force for the period I have specified herein;
– I may renew the notice of prohibition for further periods each of which must not be more than 3 years;
– If, on the expiration of the notice of prohibition, the Minister has not received notification of the renewal of the notice of prohibition, information that would identify me may be released;
– Persons who lodge a notice of prohibition will be advised in writing of the receipt of the notice of prohibition and of confirmation of the date of expiration of the notice. No further advice for the renewal of the notice will be provided;
– I may, at any time, revoke the notice of prohibition by notice in writing to the Minister in accordance with regulation 16(2) of the
NAME
SIGNATURE
DATE
NOTES
(1) Specify date the notice of prohibition is to commence. (Note, that date cannot be earlier than the date you sign the notice).
(2) Specify date the notice of prohibition is to expire (which, in accordance with section 65(4) of the Act, must not be later than 3 years after the commencement date of the notice).
1 KEY
Key to abbreviations
2 LIST OF LEGISLATION
Notified | 3 May 1994 |
Commenced | 3 May 1994 |
Assent date | 19 April 1996 |
Commenced | 1 January 1997 (s 2, s 2 |
Assent date | 26 April 2006 |
Commenced | 26 April 2006 |
Assent date | 17 May 2007 |
Commenced | s 10: 1 July 2007 ( |
Assent date | 12 December 2007 |
Commenced | Ch 1 and pts 3.3 and 5.1: 7 May 2008 ( |
Assent date | 18 November 2010 |
Commenced | 1 March 2011 (s 2, s 2 |
Assent date | 31 August 2011 |
Commenced | 21 September 2011 ( |
Assent date | 6 April 2016 |
Commenced | 1 May 2016 (s 2, s 2 |
Assent date | 19 April 2018 |
Commenced | 20 April 2018 (s 2) |
Assent date | 23 May 2018 |
Commenced | 20 June 2018 ( |
3 GENERAL AMENDMENTS
General amendments of a formal nature (which are not referred to in the table of amendments to this reprint) are made by the
4 LIST OF AMENDMENTS
r 3 amd Act No. 4, 2018, s 11
r 5 amd Act No. 4, 2018, s 11
r 6 amd Act No. 7, 2007, s 16; Act No. 40, 2010, s 202
r 7 amd Act No. 4, 2018, s 11; Act No. 10, 2018, s 6
r 8 amd Act No. 27, 1996, s 6
sub Act No. 6, 2006, s 9
r 9 sub Act No. 6, 2006, s 9
r 10 amd Act No. 27, 1996, s 7(2); Act No. 6, 2006, s 10; Act No. 4, 2018, s 11
r 11 sub Act No. 6, 2006, s 11
r 12 amd Act No. 8, 2016, s 45
rr 13 – 14 amd Act No. 4, 2018, s 11
r 15 amd Act No. 6, 2006, s 12; Act No. 28, 2011, s 3
r 17 ins Act No. 6, 2006, s 13
sch amd Act No. 6, 2006, s 14; Act No. 37, 2007, s 341; Act No. 4, 2018, s 11
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