Warning
“Queensland Statute Reprints”
QUT Digital Collections
This copy is not an authorised reprint within the meaning of the Reprints Act 1992 (Qld).
This digitized copy of a Queensland legislation pamphlet reprint is made available for non-commercial educational and research purposes only. It may not be reproduced for commercial gain.
©State of Queensland
REGULATIONS 27
THE ADOPTION OF CHILDREN REGULATIONS, 1965
[Published Gazette 3 July 1965, pp. 1247-1264; as amended by regulations pubd. Gaz. 6 August 1966, pp. 1757-1765; 23 January 1971, p. 238; 27 January 1973, p. 370; 18 May 1974, p. 565J
State Children Department,
Brisbane, 1st July, 1965.
HIS Excellency the Administrator of the Government, acting by and with the advice of the Executive Council, and in pursuance of The A doption of Children Act
0/
1964, and all other powers thereto him enabling, hereby makes the following Regulations.JOHN HERBERT.
THE ADOPTION OF CHILDREN REGULATIONS, 1965 PART I
PRELIMINARY
1. Short title. These Regulations may be cited as The Adoption of Children Regulations, 1965.
2. Commencement. These Regulations shall come into operation on the date of the commencement of the Act.
3. Parts. These Regulations are divided into Parts as follows:-- PART I-PRELIMINARY (Regulations 1-6);
PART II-CONSENTS TO AlX)PTIONS (Regulations 7-12);
PART III-ADOPTION ORDERS (Regulations 13-21);
PART IV-REGISTRATION OF ADOPTIONS (Regulations 22-37);
PART V-GENERAL (Regulations 38-40);
FIRST SCHEDULE;
SECOND ScHEDULE.
4. Repeal of existing Regulations. Subject to section five of the Act, the Regulations made under The Adoption of Children Acts 1935 to 1952, arc hereby repealed.
5. Interpretation. In these Regulations, unless the context otherwise indicates or requires, the following terms have the meanings set against them respectively, that is to say:-
"Memorandum of an adoption order"-A memorandum of an adoption order sent, pursuant to section fifty-four of the Act, to the Registrar-General; the term includes a memorandum of an adoption order compiled by the Registrar-General, pursuant to these Regulations, from a memorandum or copy of an adoption order made in another Australian State or in a Territory of the Commonwealth;
"Prescribed registering officer"-An officer of another Australian State or of a Territory of the Commonwealth ascertained by reference to the Second Schedule to these Regulations;
"The Act"-The Adoption of Children Act of 1964.
6. Forms. (1) A reference in these Regulations to a Form by number shall be read as a reference to the Form so numbered in the First Sc.hedule to these Regulations.
(2) Strict compliance with a Form in .the First Schedu~e to these Regulations is not necessary and substantial con1pliance is sufficient.
(3) A Form shall be completed in accordance with any directions contained in that Form.
I
2ft Regs. 7-10 REGULATIONS
PART II
CONSENTS TO ADOPTIONS
7. Form ofgeneral consent. A general consent shall be in accordance with Form 1, and shall be signed in the presence of, and witnessed by, one of the persons following, ihat is to say:-
(a) in the case of a general consent signed in Queensland- (i) an Officer of the Department of Children's Services;
(ii) a Barrister or Solicitor;
(iii) a Stipendiary Magistrate;
(iv) a Clerk of the Court;
(v) a Justice of the Peace;
(vi) a Commissioner of the Supreme Court for taking affidavits;
(b) in the case of a general consent signed in another Australian State OT in a Territory of the Commonwealth--any person in that State or Territory holding a corresponding office, appointment, or qualification to any of those set out in paragraph (a) of this Regulation;
(r) in the case of a general consent signed in a place outside t~lC
Commonwealth and the Territories of the Commonwcalth- an Australian Diplon13tic officer or an Australian Consular oflicer within the meaning of The Consular Fees Act 1955"
of the Commonwealth, or a Judgc) Magistrate, Justice of the Peace or Notary Public of or for that place.
,-\5 amended by reg. pubd. Gazette 6 August, 1966, pp. 1757-1765.
8. Form of consent in favour of a relative. ( I) An instrument of consent to the adoption of a child by a rchltive of the child shall be in accordance \vith Fornl 2, and shall be signed in the preseilce of, and witnessed by, the Director, or a person authorised in writing by the Director to attest that consent or generally to attest such consents.
(2) A list of the persons authorised in writing by the Director to attest generally consents refcrred to in subregulation (1) of this R.egulatioli shaH from tinlC to time be published in the Gazette.
9. Offence in relation to witnessing consents. Any person \vho drrrlands or receives any payment or reward for or in consideration of witnessing a consent to the adoption of a child shall be guilty of an offence against th~se Regulations.
10. Consents to be f~!',vardedto Director. A person \vho \vitnesses a consent to the adoption of a child shall forthwith forward the instrument of consent to the Director, accompanied hy a certificate of the \vitness stating that--
(a) the effect of giving the consent \vas explained by him to the person giving the con:;ent; and
(b) it appeared to the witness that the person giving the consent understood the mactcr contain~d ;n the instrument of C0n~ent
and th\..· crc~t of sigding the instrurTlcnt.
REGULA11IONS Regs. 11-18 29
11. Form of revocation of consent. Notice in writing of the revocation of a consent to the adoption of a child shall be in accordance with Form 3, and shall be signed in the presence of, and \\'itnessed by- (a) in the case of a revocation signed in Queensland-a person
who is enrolled as an elector of the State of Queensland;
(b) in the case of a revocation signed in another Australian State or in a Territory of the Commonwealth-a person who is enrolled as an elector of that State or l"'erritory;
(c) in the case of a revocation signed in a Country, State or l-erritory outside the Comlnonwealth and the Territories of the Commonwealth-a person who is an elector of that Country, State or Territory.
The address of the Director for the purposes of section 22 of the Act shall be ~~Kantara~" 64-70 Mary Street, Brisbane.
As amended by reg. pubd. Gazette 27 January, 1973, pp. 370-1.
12. Consent by child over 12 }'ears of age. An instrument of consent to his own adoption given by a child who has attained the age of 12 years shall be in accordance with Form 4, and shall be signed in Queensland in the presence of, and witnessed by, one of the persons referred to in paragraph (a) of Regulation 7 of these Regulations, who shall also complete the declaration set out in that Form.
PART III
ADOPTION ORDERS
13. Application by joint adopters to be placed on adoption lists.
(1) A husband ~1nd wife, resident or domiciled in Queensland, \vho \vish to adopt a child, may each make an application in accordance with Form 5 to the Director to have their names included in the adoption list.
(2) An application under subrcgulation (1) of this Regulation shall be accompanjcd by a nledicai report in accordance \vith Form 6.
14. Application for adoption. (1) Any person or persons desirous of being authorised to adopt a child may make an application to the Director in accordance with Form 7 or Form 8, whichever is appropriate.
(2) i\n application under subrcguJation (1) of this Regulation shall be signed before, and witnessed by the Director, or an officer authorised by the Director.
15. Form of interim adoption. An interirrl order nlade by the Director pursuant to section thirty-three of the Act shall be in accordance with Form 9.
16. Register of interim adoptions. The Dirc-:ctor shall cause to be kept, in such fornl as he sees fIt, a Register of Interim Orders.
17. Extension of interim adoptions. Where the Director specifies, pursuant to section 34 of the Act, that an interim order shall be in force for a further period, he shall endorse the interim order accordingly.
18. Discharge of interinl adoptions. \V'here the Director discharges an interim order, or v/here such an order CC:lses to have effect by reason df a subsequent adoption of the child, the Director shaIJ-
(a) endorse the interim order accordingly; and
30 Regs. 19-25 REGULAllJONS
(b) notify the applicant or applicants in whose favour the interim order was made of the fact of the discharge of the order, or that it has ceased to have effect by reason of the subsequent adoption of the child.
19. Form of adoption order. An adoption order made by the Director shall be in accordance with f"'orm 10, and shall be retained by the Director.
20. Director's files and orders not open ta inspection. The file kept by the Director relating to the application by any person or persons being desirous of being authorised to adopt a child, and any adoption orJer n1ade by the Director in favour of that person or persons (whether the application or order was I11ade before or after the commencement of the Act) shall not be open to public inspection or search, nor, except upon the order of a Judge of the Supreme Court, sh~ll any person be furnished with a copy of or an extract from that file or that order.
21. Record of Court proceedings not open to inspection. rIne record of any proceedings of the Supreme Court under the Act shall not be open to inspection or search, nOf, except upon the order of a Judge of the Supreme Court, or in accordance with Regulations 30 and 32 of these Regulations, shall any person other than the Director be furnished with a copy of or an extract from the record of those proceedings.
REGISTRATION ()F AOOPTI()NS
22. Adopted Children Register. (1) The Adopted Children Register may consist of such number of bound volumes as the F..egistrar-General thinks fit.
(2) lOhe Registrar-General shall compile and maintain an Index to the Adopted Children Register.
23. Form of memorandum of an adoption order. Where the Director has nlade an order for the adoption of a child the memorandum of the adoption order shall be in accordance \vith Form 11.
\\!hcrc the child is adopted by one parent alone, Of_where the I)irector considers it desirable, the \\'ords '~adoptive parent" or "adoptive parents"
shall be substituted for the word "parents" on the Schedule to Form 11.
As amended by reg. pubd. Gdzette 23 January 1971, pp. 238-9.
24. Registration of adoptions. Upon rcce~pt of a memorandum of an adoption order the Registrar-General shall register the adoption by completing column 8 of the Schedule to the memorandum under his signature and placing the mcmoranJum in the Adopted Children Register.
As anlended by reg. pubd. G,lLettc 23 January 1911, pp. L38-9.
25. Extract to he supplied. (1) Upon the registration of an adoption rursuant to Reg!Jlation 24 of these Rcgulatioi1s~the Registrar-General shaH furnish to the Director for delivery to the adopting parent or parents an extract in 3ccordance \vith r:"orn1 Q in the First Schedule to The Registration of 13irths, Deaths and Nlarriages Regulations, 1963, from the Schedule to the nlcnloranJunl of the adoption order.
(2) l-'hc cost of supplying the extract as aforesaid shall b~~ defrayed by the I)irecto[ from the fee paid to hi nl by rhe aJoptcr or ~1doptcrs for
th~ making of th~ ad()ption order.
REGULATIO'NS Regs. 26-28 31 26. Registration of adoption o,rder made in another Stilte or Territory.
Where the Registrar-General receives from the prescribed registering officer of another Australian State or of a Territory of the Commonwealth a memorandUITl or copy' of an adoption order made in that State or Territory and relating to a child whose birth or previous adoption is registered in Queensland, he shall compile from that memorandum or copy a memorandum of an adoption order which shall, subject to all necessary adaptations and modifications, be in accordance with Fornl 11, endorse thereon under his signature such particulars as he deems necessary as to the source of the information contained in the memorandum com- piled by him, and register the adoption by placing the memorandum compiled by him in the Adopted Children Register.
27. Documents received from another State or Territory not open to inspection. (1) Where the Registrar-Generai has, pursuant to these Regulations, registcrcd an adoption or an order of discharge of an adoption order made in another Australian State or in a Territory of the Commonwealth, the documents received by him from the prescribed registering officer of that State or Territory and relating to that adoption or discharge shall not be open to public inspection or search, nor, except upon the order of a Judge of the Supreme Court, shall any person be furnished with a copy of or an extract from any such do<.:ument.
(2) Where the Registrar-General has, under any corresponding previous enactnlent, registered an adoption order made in another Australian State or in a Territory of the Commonv/calth, the documents received by him and relating to that adoption shall not be open to public inspection or search, nor, except upon the order of a Judge of.the Supreme Court, shall any person be furnished with a copy of any such document or any extract from any such document other than an extract therefroIIl in accordance with Form Q of the First Schedule to The Registration of Births, Deaths and Marriages Regulations, 1963.
28. Notation of adoption in other Registers. Tn every case wh(~re a menlorandum or copy of an adoption order received by the Rcgistrar- General pursuant to these Regulations sufficiently identifies the adopted child with a child whose birth or previous adoption is registered in Queensland, the Registrar-General shall-
(a) in the case of a child whose birth is registered in Queensland- make a marginal notc to the entry of birth of the child in the Register of Births and in any Index thereto sufficient to indicate to him or to any authorised officer of the General Registry of Queensland the fact that the child mentioned in thc entry has been adopted, and shaH al~o,
where the birth has been entered in a }{egister of Births kept by a district registrar, cause the district registrar to nlake a sinlilar marginal notc to that entry and in any Index to that Register,
(b) in the case of a child whose previous adoption is rcgistered in Quccnsland-
(i) whcIe that adoption was registered pursuant to any corresponding previous enactnlent----n'Jakc a n"larginal pote to the copy of the adoption order kept in the i\Joptcd Children Register and in any Index thereto; or
32 Regs. 29-31 REGULATIONS
(ii) where that adoption was registered pursuant to the Act- make a marginal note to the memorandum of the adoption order registered in the Adopted Children Register and in any Index thereto,
sufficient to indicate to him or to any authorised officer of the General Registry of Queensland the fact that the child mentioned in the copy of the adoption order or in the memorandum of the adoption order has been re-adopted.
29. Cancellation of previous entries or registrations. \Vhel'e a marginal note has been made pursuant to Regulation 28 of these Regulations, or under any corresponding previous enactment, against the entry of a birth in any Register of Births and in any Index thereto, or against the copy of the adoption order kept in the Adopted Children Register, or against the memorandunl of the adoption order registered in the Adopted Children Register, and in any Index to the Adopted Children Register, the entry of the birth, or registration of the adoption, as the case may be, sh?ll be deemed to be cancelled and shall not be open to public inspection or search, nor, except upon the order of a Judge of the Supreme Court, shall any person be furnished with a copy of or extract from that entry, copy of the adoption order, or memorandum of the adoption order.
30. Registration of order of discharge of a Queensland Adoption Order. Where the Registrar-General receives from the Registrar of the Supreme Court a copy of an order made under the Act for the discharge of an adoption order, the Registrar-General shall-
(a) make a marginal note to the memorandum of the adoption order (or, in the case of an adoption made prior to the commencement of the Act, to the copy of the adoption order) kept in the Adopted Children Register;
(b) where, consequent upon the adoption order, a marginal note has previously been made (whether pursuant to these Regulations or under any correspondiilg previous enactment) to an entry of birth in a Register of Births and in any Index thereto, or to a copy of an adoption order kept in the Adopted Children Register or a memorandum of an adoption order registered in the Adopted Children Register and in any Index to the Adopted Children Register, make a further marginal note to that entry, copy or memorandum and in that Index indicating that the adoption order has been discharged, and, where such a marginal note has been made in a Register of Births kept by a district registrar, and in an Index thereto, cause the district registrar to make a similar further marginal notc to that entry and in that Index; and (c) send a copy of the discharging order, certified in \vriting by
him to be a true copy, to the Director.
31. Registration of discharge of 3n adoption order made in another State or Territory and registered in Queensland. Where an adoption order made in another Australian State or in ~ Territory of the Common\vealth has been, pursuant to these Regu]ntions (nr U'1cfcr any corresponding previous ennctment), registered in Queensland. and the
I~egistrar-Genera]receives from the prescribed r~gisteringauthority cf that
REGULAnONS Regs~32, 33 33 State or Territory a memorandum or copy of an order made under t:le law of that State or Territory discharging the adoption order, the Registrar-General shaII-
( a) register the order of discharge by making a marginal note to the memorandum of the adoption order (or, in the case of an adoption registered prior to the commencement of the Act, the copy of the adoption order) kept in the Adopted Childre'n Register; and
(b) where, consequent upon the adoption order, a marginal note has previously been made (whether pursuant to these Regula- tions or under any corresponding previous enactment) to an entry of birth in aRegister of Births and in any Index thereto, or to a copy of an adoption order kept in the Adopted Children Register or a menlorandum of an adoption order registered in the Adopted Children Register and in any Index to the Adopted Children Register, make a further marginal note to that entry and in that Index indicating that the adoption· order has been discharged, and, where such a marginal note has been made in a Register of Births kept by a district registrar, and in an Index thereto, cause the district registrar to make a similar marginal note to that entry in that Index.
32. Copies of Queensland orders to be sent to other States and Territories. (1) Where the Registrar-General receives from the Director a memorandum of an adoption order, ~nd the Registrar-General has reason to believe that the birth or previous adoption of the child is registered in another Australian State or in a ~rerritory of the Common- wealth, he shall send a copy of the memorandum of the adoption order certified in writing by him to be a true copy of the memorandum of the
£'doption order to the prescribed registering officer of that State or Territory.
(2) Where the Registrar-General receives from the Registrar of the Supreme Court a copy of an order discharging an adoption order, and the Registrar-General has reason to believe that the birth or previous adoption of the child is registered in another State or in a Territory of the Commonwealth, he shall cause a copy of the order of dis~harge,certified in \vriting by him to be a tr~e copy of the order of discharge, to be sent to the prescribed registering officer of that State or Territory.
33. Effect of discharge of adoption order. (I) Where an adoption order registered in Queensland and relating to a child whose birth is
registered in Queensland has been discharged-
(a) the cancellation of the entry of the birth in the Register of B1rths shall be deemed to have been rescinded and the provisions of Regulation 29 of these Regulations shall no longer apply with respect thereto, and, subject to ~ub
regulation (3) of this Regulation, no person shall be furnishc"d
\vith a copy of or an ext::-act from that entry contaiiling any particulars relating to any mc.rgin8.! note relating to (\n adoption Of the discharge of an adoption made against that
cntry~
(b) the nlclnorandum of the adoption order (Of, i~ the case of an adoption registered prior to the commencement of the Act, the copy of the adoption order) shall not be open to public
34 Reg. 34 REGULA11IONS
inspection or search, nor, except upon the order of a Judge of the Supreme Court, shall any person be furnished with a copy of or an extract from that memorandum or copy.
(2) Where, pursuant to subsection (4) of section sixteen of the Act, the Supreme Court, upon discharging an adoption order, orders that the child ~hall be known by a name other than the name in which the birth of the child was originally registered, the Registrar-General shall cause the particulars of such change to be note'd in the margin of any entry of birth or marriage relating to that child.
(3) Notwithstanding the provisions of paragraph (a) of subregulation (1) of this Regulation, a copy of or an extract from an entry of birth relating to a child in respect of whom an adoption order has been discharged may contain particulars of a' marginal note relating to a change of name resulting from an order of the Supreme Court made consequent upon the order discharging the adoption order.
34. Evidence and search. (1) The Adopted Children Register and any memorandum of an adoption order (or, in the case of an adoption registered prior to the commencement of the Act, any copy of an adoption order) contained therein shall be respectively a book and document of such a public nature as to be admissible in evidence on its mere production from proper custody, and the Registrar-General shall be the person having the proper custody thereof.
(2) Subject to Regulation 33 of these Regulations and subject as hereinafter provided, 6very person is entitled to cause the Rcgistrar- General to have a search made of the Index to the Adopted Children Register and to obtain from the Registrar-General a copy of or an extract from the Schedule to the memorandum of an adoption order (or, in the case of an adoption registered prior to the commencement of the Act, the Schedule to the copy of an adoption order) contained in the Adopted Children Register, certified to be a true copy or extract under the seal and signature of the Registrar-General:
Such copy shall be ip the form of the Schedule to Form 11 with such adaptations and modifications as may be necessary, and in respect of adoption orders made prior to 16th January, 1971, where the child is adopted by one parent alone, or where the Registrar-General considers it desirable, the \vords "adoptive parent" or Hadoptive parents" shall be substituted for the word Hparents" on such copy. Any such copy in a fonn adapted or modified as aforesaid or having the words Hadoptive parent" or 104adoptive parents" substituted for the word "parents" as provided herein shall if otherwise correct be deemed to be a true copy.
Such extract shall be in accordance with Form Q as referred to in Regulation 25 hereof.
Provided that, except upon the order of a Judge of the Supreme
~ourt, no person shall be furnished with a copy of or an extract from any part of such memorandum of an adoption order or copy of an adoption order, other than the Schedule thereto:
Provided further that the provisions of section twenty-two of The Registration of Births, Deaths and i\1arriagcs Act of 1962 shall apply and extend to any such seJfch and to the supply of any such copy or extract.
As amended by reg. pubd. Gazette 23 January J971, pp. 238-9.
REGULATIONS Regs. 35-39 35 35. Correctionof errors. (1) Where the Director is satisfied that any adoption order or any memorandum of an adoption order contains an error or mis-statement, or that any particulars which should have been contained therein have been omitted therefrom, he may correct the adoption order, or the memorandum of an adoption order, as the case may be, by causing the ~rue particulars, or the omitted particulars, as the case may be, to be entered therein. Where such a memorandurn of an adoption order has been sent to the Registrar-General, the Director shall advise the Registrar-General of such error or mis-statement or omission, as the case may be.
(2) Where the Registrar-General is satisfied that any memorandum of an adoption order (or, in the case of an adoption registere.d prior to the comnlencement of the Act, any copy of an adoption order) contained in the Adopted Children Register contains an error or mis- statement, or that any particulars \vhich should have been contained thcrein have been omitted therefrom, he lTI3Y correct the Register by causing the true particulars, or the omitted particulars, as the casc may be, to be entcred in the memorandum or copy and may make or cause to be nlade ~uch consequential alterations or additions to any marginal note to any entry of birth in a Register of Births as he considers necessary.
A\ anlcnded by reg. pubd. (j~izette 18 fv1ay 1974, p. 565.
36. Notification to another State or Territory of correction of error.
\Vherc the Registrar-General, pursuant to Regulation 35 of these Regula- tinns. nlakes any correction relating to the registration of the adoption of a child, and the Registrar-General has reason to believe that the birth or previous adoption of the child is registered in another Australian State or in a Territory of the Commonwealth, he shall, as soon as practicable, cause a notification of the correction to be sent to the prescribed registering officer of that State or Territory.
37. Prescribed registering officer. For the purposes of these Regula- tions the prescribed registering officer of another Australian State or of a Territory of the Commonwealth specified in the first column of the Second Schedule to these Regulations is the officer of that State or Territory specified iL the second column of that Schedule opposite to the name of that State or Territory.
PART V
GENERAL
38. Offence. Any person \\'ho contravenes any provision of these Regulations shall be guilty of an offence agaInst these Regulations.
39. Pl1nalty. Any person guilty of any offence against these Regula- tions shall be liable, if no specific penalty is provided for that offence, on sunlnlary conviction, to a fine not exceeding one hundred dollars or to inlprisonnlcnt for a tern1 not exceeding three months.
Decimal currency reference ~ub~tituted pursuant to section 7 of Decinlal Currency Act of 1965.
36 Regs. 40,41 REGULATlIONS
40. Fees. The fee to be paid to the Director by the applicant or applicants for the making of an adoption order shall be five dollars which shall be. inclusive of the cost of the extract to be supplied t.o the applicant or applicants pursuant to Regulation 25 of these Regulations:
Provided that the Minister may, in a particular case or in a particular class of case, waive the payment of any fee due under this Regulation.
Decimal currency reference substituted pursuant to section 7 of Decinlal Currency Act of 1965.
41. In any proceeding under the Act, the Register of Children required to be kept by section 35 of The Children's Services Act of 1965 and the record of visits required to be kept by Regulation 52 (2) of The Children's Services Regulations of 1966 or a certified copy of an entry in such register or record or a certificate or extract giving particulars of such an entry and purporting to be signedby the person who made such entry shall be prima facie evidence of the keeping of such register or record and of the facts stated therein.
Inserted by reg. pubd. Gazette 6 August 1966, pp. t757-65.
REGULl\TIONS Sch. I,f.1 37
~rHE FIRST SCHEDULE [Form 1]
QUEENSLAND
Adoption 0/ Children Act 1964-1972
FORM OF GENERAL CONSENT BY PARENT ORGUARDIAN TO ADOPTION ORDER
(Sections 20 (1) and 23 (1»
In the matter of the Adoption of Children Act 1964-1972;
and In the matter of: a chiid.
J, [Name ill full], the undersigned, of [Address in full], in the State of being {he [State relationship] of the above named child who was born at
in the State of , on the day of 19
hereby state-
( I) I understand .the nature and effect of an Adoption Order for which application Inay be made.
(2) In particular I understand that the effect of such order ~Iill be to deprive me permanently and totally of my parental rights in relation to the said child.
( 3) I hereby consent to the making of an Adoption Order in respect of the said child in favour of any person or persons whose application for an Adoption Order in respect of the said child is approved by the Director.
(4) No other person is required to consent to the adoption of the said child:
or-
The consent of , of , who is the
of the said child, is also required.
(5) I desire the said child to be brought up in the faith.
(6) I hereby acknowledge and admit that section 22 of the Act as follows has been read and explained to me:-
Rerocation of consents. (1) A consent to the adoption of a child given for the purposes of this Act or the repealed Acts by a person other than the child may be revoked by notice in writing served on the Director before-
(a) the expiration of thirty days fronl the date on which the instrunlent of consent was signed; or
(b) the day on which an order for the adoption of the child is n1ade, which- ever is the earlier, but may not otherwise be revoked.
(2) Service of a notice on the Director under subsection (1) of this section shall be effected by deiivering it to him personally or by sending it to him by registered post at such address as is prescribed.
In witness whereof i have signed this consent on the day
of ,19 ,at , in the State of
Signature:
Signed in the presence of-- Signature:
Address:
*Qualification:
(*See below for list of authorised witnesses)
CERTIFICATE OF WITNESS
I, , the abovenamed witness, hereby certify that, before the above- named signed the above instrument of consent, the effect of his/her signing the instrument \-vas explained by me to him/her and it appeared to me that he /she understood the effect of signing the instrument.
Signed:
ACCEPTANCE OF GUARDIANSHIP (SECTION 27)
I . Of taccept
hereby slgnl y that I tdecline to accept guardi<lnship of the child in respect of whom this consent is given.
Witness: Director.
Authorised Officer.
38 Sch.I~f.2 REGULATIONS
The person witnessing this consent must forward it to the Director, Depa rtment of Children's Services, UKantara," 64-70 Mary Street, Brisbane, or to the Distric:t Officer, Department of Children's Services, Rockhampton or Townsville, whichever place is nearer.
Substituted by reg. pubd. Gaz. 27 January]973, pp. 370-1.
*List of authorised witnesses:-
(a) an Officer of the D~partment of Children's Services;
(b) a Barrister or Solicitor;
(c) a Stipendiary !\1agistrate;
(d) a Clerk of the Court;
( e) a Justice of the Peace;
(f) a Commissioner of the Supr erne Cou11 for taking affidavits.
,Strike out \vhichever inapplicable.
[Form 2]
QUEENSLAND
Adoption of Children Act 1964-1972
FORM OF CONSENT BY PARENT OR GUARDIAN TO ADOPTION ORDER IN FAVOUR OF A RELATIVE
(Sections 20 (2) and 23 (2») In the m~ltter of the Adoption of Children Act 1964-1972;
and In the matter of: a child.
I, [Nalne ill filiI], the undersigned, of [Addrpss in fllll], in the State of being the [State relationship] of the abovenamed child who was born at
in the State of , on the day of , 19
hereby state-
(1) I understand the nature and effect of an Adoption Order for which application may be fnade.
(2) In particular J understand that the effect of such order will be to deprive me permanently and totally of my parental rights in relation to the said child.
( 3) IIhereby consent to the making of an Adoption Order in respect of the said child in favour of , a/an [State relationship to child].
(4) No other person is required to consent to the adoption of the said child;
0'-
The consent of , of , who is the
of the said chIld, is also required.
( 5) I desire the said child to be brought up in the faith.
(6) I hereby acknowledge and admit that section 22 of the Act as follo\\'s has been read and explained to me:-
Rel'ocafiofl of consents. (1) A consent to the adoption of a child given for the purpos~s of this Act or the repealed Acts by a person other than the child may be revoked by notice in \\'riting served on the Director before-
(a) the expiration of thirty days from the date on which the instrument of consent was signed; or
(b) the day on which an order for the adoption of the child is made, whi cheve r is the earl ie r. bIIt may no lot herwise be re \'0k.eJ .
(2) Service of a notice on the Director under subsection (1) of this section shall be effected by delivering it to him personally or by sending it to him by registered post at such address as is prescribed.
In witness whereof I have signed this consent on the day
of ,19 ,at , in the State of
Signature:
Signed in the presence of-- Signature:
Address:
*Qualification:
REGULATIONS Sch. I,ft.3, 4 39
CERTIPICATE OF WITNESS
I, , the abovenamed witness, hereby certify that, before the aboven8med signed the above instrument of consent, the effect of his/her signing the instrument was explained by me to him/her and it appeared to me that he/she understood the effect of signing the instrument.
Signed:
ACCEPTANCE OF GUARDIANSmp (SECTION 27)
I hereby sIgn I y. ·f that I ttdecline to acceptaccept guardianship of the child 1n respect of whom this consent is given.
Witness:
Director.
Authorised Officer.
The person witnessing this consent must forward it to the Director, Department of Children's Services, "Kantara," 64-70 Mary Street, Brisbane, or to the District Officer, Department of Children's Services, Rockhampton or Townsville, whichever place is nearer.
*This consent shalf he witnessed only by the Director or a person authorised in writing by the Director.
tStrike out \vhichevcr inapplicable.
Substituted by reg. pubd. Gazette 27 January 1973, pp. 370-1.
[Form 3]
QUEENSLAND
The Adoption of Children Act of 1964
FO~1 OF REVOCATION OF CONSENT TO THE ADOPTION OF A CHILD
(Section 22)
In the matter of The Adoption of Children Act of 1964
and
In the Inatter of:
a child.
I, [Name in luI!], the undersigned, of [Address in full], in the State of hereby revoke the consent given by me on the day of
19 ) and banded to
In witness whereof I have signed this notice of revocation of consent on
the day of ,19 ,at , in the State of
Signature:
Signed in the presence of: [Full name oj }i.litness]
Signature:
Address:
Elector for the Electoral District of , in the State/TerritoryICountry of
For this Revocation of Consent to be effective, it. must be served on the Director, De.partment of Children's Services, Kantara. 64-70 \1~lry Street, Brisbane.
either personally or by Registered Post, within thirty days from the date on which the Consent was signed or prior to the day on \vhich an Order for the Adoption of the Child is made, whichever is the earlier.
.A.s amended by regs. pubd. CJazette. 6 /\Ugllst 1966. pp. 1757-65: 27 Janu:Jry 1973, pp. 370-1.
[Form 4]
QUEENSLAND
The Adoption of C'Il ildrcn Act of 1964
FORM OF CONSE~T BY CHILD \\'110 HAS ATTAINED THE AGE OF TWELVE YEARS (Section 26)
In the ma~ter of an Application under the provisions of The Adoption oj Children .4Cl oj ]964. L [Insert n(u[Jc]. who ~lm at rrescnr in the care and custody 0f [Ins~rt full !ll]nzt, address and occupation] and have attained the age of
40 Sch. I,f.5 REGULATIONS
twelve years, hereby consent to the making of an Adoption Order under which I shall be the adopted child of [Insert full nanle, address and occupation of applicant/
applicants] under the provisions of the abovementioned Acts.
In witness whereof I have signed this consent on the day of
19 ,at , in the State of
Signature:
Signed in the presence of-
· Signature:
Address:
*Qualification:
(*See below for list of authorised witnesses)
The person witnessing this consent must forward it to the Director, Department of Children's Services, Kantara, 64-70 Mary Street, Brisbane, or to the District Officer, Department of Children's Services, Rockhanlpton or l'ownsville, whichever place is nearer.
CERTIFICATE OF WITNESS
I, , the abovenamed witness, hereby certify that, before the abovenamed signed the above instrument of consent, the effect of his/her signing the instrument was explained by me to him/her and it appeared to me that he/she understood the effect of signing the instrument.
Signed:
*List of authorised witnesses~-
(a) an Officer of the Department of Children's Services;
(b) a Barrister or Solicitor;
(c) a Stipendiary Magistrate;
(d) a Clerk of the Court;
(e) a Justice of the Peace;
(I) a Commissioner of the Supreme Court for taking affic':\vits.
As amended by reg. pubd. Gazette 6 August 1966, pp. 1757-65; 27 January 1973, pp. 370-1.
[Form 5]
QUEENSLAND
The Adoption of Children Act of 1964
ApPLICATION FOR NAMES TO BE INCLUDED IN ADOPTION LIST
(Section 17)
We, the undersigned, resident at , in the State of , and domiciled in the State of ('phone ) hereby make application to have our names included in the Adoption List for a [Please state preference- male or felnale] child.
The foJlowing particulars are submitted:-
Husband Wife
Full Name Maiden Surname Date of Birth Place of Birth Occupation Employed by
Nett Week.ly Wage or Annual Income
Religion
Extent of Education
Religion in which child will be reared:
When and where were you married?
REGULATIONS Sch. I,f.6 41 If you have any children, either your own or adopted. state their names, age~ and
sex, and in the case of adopted children, date of adoption:
Do you own your own home?
(If not, give particulars of place of abode.) If the home is under mortgage, state to what extent:
Approximate value of home?
(Including land and furniture.)
Particulars and approxim(l.te value of any other assets, including motor vehicles, land or other property, Bank Account, investments:
Are you covered by Life Insurance?
(If so, give details.) Reasons for this application:
If you are unable to have your own children, set out names of medic81 practitioner or practitioners consulted:
(Attach supporting medical certificate.)
Particulars of any previous marriage by either husband or wife:
(If divorced, attach divorce decrees.)
FEATURES
Husband:
Hair:
Eyes:
Complexion:
Height:
Build:
Wife:
Hair:
Eyes:
Complexion:
Ileight:
Build:
Signed at Signature:
Si2natur~:
on the day of
Witness:
Witness:
, 19
[Form 6]
QUEENSLAND
The Adoption of Childri'n Act of 1964
MEDICAL REPORT-PART I: PERSONAL STATEMENT BY ,\PPLICANT
(Section 14)
This Form must be. completed by the applicant and given to the examining doctor who will complete Part 2 and forward both parts to the Director, Departrnent of Children's Services. Where a joint application is made, a declaration by each applicant is required.
Name: [Surname in BLOCK Letters], [Christinn Names].
Age: Occupation:
Address:
Number of Children in Family (Give ages and sexes):
1. Have you any physical deformity? YES/NO~
If so, what?
2. Have ~/OU suffered from any of the following? (Underline the item) :
Rheunlatic felver; Continued pains in joints or muscles; Epilepsy; Fits; Giddiness;
Asthma; Hay Ffver; Persistent sore throats; Antrum disease; Spitting of blood;
C:ontinued cough: I)ifficult breathing: Pleurisy; Bronchitis; Palpitation of the heart;
Heart disease; Chest pain; Persistent indigestion: Hepatitis; Kidn~y or hladder trouble; Dermatitis or persistent skin eruptions; Varicose veins; Persistent diarrhoea; Nervous trouble or breakdown; Ear trl)uble or ear discharge.
3. Have you ever heen rejected or deferred for Life Assurance? YES/NO.
42 Scb.i, f.6 REGULArrIONS
4. Has any member of your family suffered from Heart disease; Diabetes;
l~uberculosis: Stroke; High blood pressure; Nervous trouble; Mental trouble or fits; Cancer? If so, state which:
5. State illnesses from which you have suffered during your lifetime:
6 State injuries which you have suffered during your lifetime:
1. State operations which you have undergone during your Jifetime:
8. Do you know of any reason why you should not live long enough to see the child reach adulthood? YES/NO. IfYES, state reason:
9. Is there any matter concerning your present or previous health not mentioned above? YES/NO. If YES, state what:
I declare all the above answer~ to be, to the best of my knowledge and belief, true and correct, and will fully reveal to nlY examining doctor all circumstances known to me concerning my health and fitness, and am fully aware that any false statement InC1de by nle, whether orally or in writing, in connection with this report~
render'! me liahle to d pen~dty under the said :\ct.
PhJcc:
Applicant's signature.
Date:
MI.OIC\L RI'PORT-PART II: EXAr--UNATION BY RE(jJSTERED WlEDICAL PR.~C·tITIONER
Thi" form will he tre(~ted as strictly confidential and its Contents will not he divulged to lJnauthorised Persons. t\1edical Practitioners are advised to post Both Parts of this Form, in an envelope marked HCo~fidentiaI," to the Director, Departnlent of Children's Services, Knntara, 64-70 Mary Street, Brishane.
C' ()nt ,:;JItS 0f Part I I 0f this Form \\1i11 nCJt he div u )gedt0 the A pP11 cant.
Naolc of Ji\ppl icant: Age:
Occupation:
Address:
Applicant's Medical History:
(Sufficient details of physical or mental disorders, injuries, etc., which the patient has suffered to help in the decision as to whether the applicant is suitable to adopt a child should be stated.)
Is there a Family History of Nervous or Mental Disorders? YE.S/NO.
Examination of the Applicant:
1. Is there any evidence of nervous or mental disease?
2. Is there'any evidence of disease or weakness of the heart or cardiovascular
sY5tem? (Blood Pressure: Systolic: Diastolic: )
3. State your opinion re condition of lungs including recent X-ray findings:
(Chest X-ray Date: )
(Result: )
4. (a) Is there any evidence of disease of the genito-urinary system?
(b) Examination of Urine: Colour: Albumen:
Sugar:
5. Is there any evidence of disease of the alilnentary tract?
6. Is there any evidence of disease of the central nervous systcln?
7. Is there any visual defel:t or disease of the eyes?
8. (a) Is there any Jefect in hearing or speech?
(b) I~ there any ear, nose or throat disorder?
9. Is there any evidence of skin disease?
10. Is there any evidence of disease of the bones or joints?
II. Do you advise further special investigations? If so, in what specialty?
12. Would you comment on-
(a) The physique and physical health of the applicant:
(b) Mental ~nd emotional stability of the applicant:
(c) Whether the applicant is psychologically suitable to be a good parent:
Doctor's Signature:
Date of Examination:
Doctor's Addres..,:
As amended by regs. pubd. Gazette 6 August 1966, pp. 1757-65; 27 January 1973, pp. 370-J.
I~EGULATIONS Sch. I,ff.7,8 43 [Form 7]
QUEENSLAND
The Adoption of Children Act of 1964
ApPLICATION TO ADOPT A CHILD (By SOLE i~DOPTER)
(Sections 7 and 12 (2)) To the Director, DepJrtnlcnt of Children's Services.
(1) I, the undersigned [Na!ne in full], resident at [A ddrcss in full], in the
State of and domiciled in the State of am
desirous of being authorised under The Adoptioll of Children Act of 1964, to adopt 3 child of the sex, hereinafter called
"the child".
(2) What is your occupation?
(3) Are you resident/ domiciled in Queensland?
(4) (To beansH,"eredby fenlale applicantif applicable) My maiden surname was
(5) Are you over the age of 21 years?
(6) Where were you born?
(7) I am of good repute and am a fit and proper person to fulfil the responsibilities of a parent of the child.
(8) I request that the child, upon his/her adoption, shall have the following name:
(9) J have not received or agreed to receive, and no person has made or given or agreed to make or give to me any payment or reward for or in consideration of the adoption, except as follows, viz:-
In witness whereof I have signed this application at , on the
day of , 19
Signature of Applicant:
• Signature of Witness:
*This application shall be witnessed only by a person authorised by the Director, Departnlcnt of Children's Services.
As amended by reg. pubd. Gazette 6 August 1966, pp. 1757-65.
[Form 8]
QUEENSLAND
The Adoptiofl 0/ Children A ct of 1964 :\PPLICATION TO /\DOPT A CHILO
(BY HUSBAND AND WIFE) (Sections 7 and 12) To the I)ircctor, I)cpartment of Children's Services.
(1) We, the undersigned, , of , in the State of
, and , of , in the State of ,
are de~irous of being authorised under Tile Adoption 0/ ('hi/Lirell Ac:t of 1964 to adopt a child of the sex, hereinafter called
"the child".
(2) (To be conlp/cted sC{Jarafely by each applicant)
I, , anl by occupatiof!, and am resident/
donliciled in Queensl ano.
I. anl by occupation, and am resident!
domiciled in Queensland.
(3) (To he ('onlp/cted h.v /Cl1zo/c (Jr{J!iC(/llt)
~vly m~liden\.)Llr n~Ime V,Ia')
44 Scb.I,If.9, 10 REGULATIONS
(4) (To be conzpleted separately by each applicant)
I, , am not under the age of 21 years, bei ng born at on
I, am not under the age of 21 years, being born at on
(5) We are of good repute and are fit and proper persons to fu Iftl the responsibilities of parents of the child.
(6) We request that the child, upon his/her adoption, shall have the following name:
(7) We have not received or agreed to receive, and no person has made or given or agreed to make ,?r give to us or to either of us any payment or reward for or in consideration of the adoption, except as follows:
In witness whereof we have signed this application at , on the
day of , 19
Signature of Male Applicant:
Signature of Female Applic.ant:
*
Signature of Witness:*
Signature of Witness:*This applic.ation shall be witnessed only by a person authorised by the Director, Departnlent of Children's Services.
As amended by regs. pubd. Gazette 6 i\ugust 1966, pp. 1757-65.
[Form 9]
QUEENSLAND
'[he Adoption of Children A ct of 1964 INTERIM ORDER
(Section 33) In the matter of an application for the adoption of
, 19 , of , for an order (2)
(3)
( 1) Whereas an appIJcation has been made to me by
, and , of
for the adoption of , a child;
And I am satisfied that I could lawfully make an order for the adoption of the said child by the applicant/ applicants but, postpone the determination of the
application until the day of , 19 ,and order that
the applicant/ applicants have the care and custody of the said child until that date.
This order is subject to the following terms and conditions:-
Dated at t this day of
Director,
Department of Children's Services.
As amended by reg. pubd. Gazette 6 August ] 966, pp. 1757 -65.
[Form 10]
QUEENSLAND
The Adoption of ('!lildrell Act of 1964 ADOPTION ORDER
(Section 7)
WHEREAS
( 1) Application has been made by the. State of , and
, of adopt a child of the
, of in the State of sex;
in
t to
