______________________________________________________________________________

CERTIFICATE OF ADOPTION

IN THE ________ COURT

OF THE STATE OF OREGON

FOR THE COUNTY OF

___________

In the Matter of the Adoption of:

___________________________

File No.___________

Name after Adoption

This is to certify that on the ___ day of________, 2___, a Judgment of Adoption was granted by the Honorable Judge ____________ granting the adoption of the above-named person by _________________.

The adopted person, above named, was born in the City of___________, County of________, State of________, on the __ day of_____, 2__.

Dated at________, Oregon, this __ day of___, 2__.

(SEAL) By _______________

Deputy

______________________________________________________________________________

(2) The certificate of adoption may be issued by the judge who granted the adoption, instead of by the clerk of the court.

(3) The certificate of adoption shall not state the former name of the person adopted, unless the name was not changed by the judgment, and shall not state the name of either biological parent of the person adopted. However, if the adoption was by the adopted person’s stepparent, the name of the adopting stepparent’s spouse may be set forth in the certificate if requested.

(4) No certificate of adoption shall be issued to any person other than the persons described in subsection (1) of this section without order of the court.

(5) For all purposes, the certificate of adoption shall constitute legal proof of the facts set forth therein, shall have the same force and effect and the same presumptions of validity as the judgment of adoption, and shall be entitled to full faith and credit. [1979 c.397 §2; 1985 c.496 §24; 2003 c.576 §157; 2015 c.512 §2]