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Blank Texas Adoption Papers PDF Template

The Texas Adoption Papers form is a legal document used to amend a birth certificate following an adoption. This form allows adoptive parents, adult adoptees, or their attorneys to request changes to the birth record to reflect the new family structure. Proper completion and submission of this form are essential for ensuring that the adoption is officially recognized in the state's vital records.

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Blank Texas Adoption Papers PDF Template

Contents

Form Example

Amending a Birth Certificate

based on Adoption

Who Can Apply for a Correction?

•The person named on the birth certificate, if at least 18 years of age.

•Adoptive Parent(s) of the person named on the birth certificate.

•Attorney representing the adoptive parent(s) of the person named on the birth certificate.

•District clerks (district clerks do not need to complete sections 6 and 7).

How Do I Make a Correction?

☐Complete all sections and sign the Certificate of Adoption. See pages 3 and 4.

☐Section 5 on page 3 MUST be completed and certified by the clerk of the court.

☐The applicant must ATTACH A COPY OF THEIR VALID PHOTO ID. If the District clerk is submitting the application, the clerk needs to provide as a form of ID a cover letter on office letterhead referencing the adoptee(s).

☐The application must be original. Photocopies, alterations, strike-through, or write overs will not be

accepted.

☐Submit a certified copy (with original certification) of the final decree of adoption if section 5 is not complete or certified.

☐Submit the appropriate fees. See fee schedule below.

For Frequently Asked Questions, go to: https://www.dshs.texas.gov/vs/faq/#adopt

Where Do I Mail the Application?

Regular Mailing Instructions - Estimated processing time is 6-8 weeks.

See https://www.dshs.texas.gov/vs/processing/ for current times.

Please submit your application, supporting documents (if required) and fees to:

DSHS – Vital Statistics Section, P.O. Box 12040, Austin, TX 78711-2040.

Expedited Service Mailing Instructions - Estimated processing time is 20-25 business days.

The order and $5.00 processing fee must be sent to the Vital Statistics Section via an overnight mail service such as: FedEx, Lone Star, or UPS.

Please submit your application, supporting documents (if required) and fees to:

DSHS-Vital Statistics Section, MC 2096, 1100 W. 49th Street, Austin, TX 78756.

•

FAILURE TO PROVIDE INFORMATION REQUESTED ON THIS FORM, MAY RESULT IN SIGNIFICANT

PROCESSING DELAYS AND/OR DENIAL OF YOUR APPLICATION.

•

Fees: How much must I submit?

Fee Schedule			Fee ($)	Qty (#)		Total ($)
Filing Fees:
O	Correction to Birth Certificate based on adoption	$25.00			=	$25.00
Birth Certificate(s):
O	Certified Corrected Birth Certificate ($22.00 per copy)	$22.00		X	=
Central Adoption Registry Fee:
O	Central Adoption Registry Fee (per adoption decree granted in Texas)	$15.00			=	$15.00

For urgent requests, orders may be EXPEDITED by paying the below expedited processing fee AND sending the order through an overnight mail service, such as: FEDEX, LoneStar, or UPS to: DSHS-Vital Statistics Section, MC 2096, 1100 W. 49th Street, Austin, TX 78756.

O	Expedited processing Fee	$5.00		=

All orders are returned free of charge by USPS regular mail. For expedited return mail service, select one of the overnight return shipping methods below.

O	Expedite Overnight Mail (shipping within USA)	$12.50	=

O	USPS Express Overnight Mail (shipping overnight to PO Box ONLY)	$22.95	=

	Grand Total

Fees may be combined in one check or money order made payable to DSHS – Vital Statistics

For the status of your request, contact VSS by telephone at 1-888-963-7111 or online at: https://www.dshs.texas.gov/orderstatus/.

Page 1 of 4

VS-160 (Rev. 3/22)

INSTRUCTIONS:

Once the application is approved, a new birth record will be filed with the adoption information.

Section 1: Birth Certificate Information

•The information completed in this section should show the child’s information prior to this adoption. This is required to locate the birth certificate our office will be amending.

•The child’s name, date of birth, sex, and place of birth are required.

•Parents’ names are required for Texas-born adoptions; parents’ names are not required for foreign-born adoptions.

Section 2: Information for New Birth Certificate

•This section must show the adoptive parents information. Do not list married name as maiden name.

•If this is a step-parent adoption, the biological parent’s information should also be included in this section. A step-parent adoption is NOT a single parent adoption.

•All items in this section are required. Incomplete applications will not be processed.

Section 3: Parent’s Signature

•An adoptive parent’s signature is required. Incomplete applications will not be processed.

Section 4: Attorney/Placing Agency Information

•Include the name, address and telephone number of the attorney of record.

•If applicable, include the child placing agency or managing conservator.

Section 5: Certification of the Court

•This section must be completed by the clerk of the court granting the adoption, including the new name of the child.

•If this section is not certified by the clerk of the court granting the adoption, then the applicant may complete this section and must submit a certified copy (with the original certification) of the final decree of adoption. The adoption decree must properly identify the birth record to be amended – including the child’s original name, date of birth and adoptive name. For foreign-born adoptions, the adoption decree must also include the country of birth.

Please note: All documents, both certified and photocopied, submitted will be retained by our office and placed in a sealed file. A court order is required to unseal a file. Parents should keep copies of certified documents for their records and future use before sending them.

Section 6: What is Your Name? (Applicant’s Information)

•This section must be completed with the applicant’s contact information and relationship to the person named on the birth certificate. District clerks do not need to complete this section.

•This section must include to whom our office will mail the newly filed birth certificate.

•A copy of the applicant’s valid photo ID must be included with the application.

Section 7: Would the applicant like to order a certified copy of the new birth record?

•The information completed in this section is used by our office to determine if a certified copy of the newly filed birth certificate reflecting the adoptive information is being ordered and the number of certified copies being ordered. District clerks do not need to complete this section.

•If a birth certificate is not ordered, this section does not need to be signed in the presence of a notary public, county clerk, or other person authorized to administer oaths.

•If a birth certificate is ordered, this section must be signed by the applicant in section 6: one of the adoptive parents, the adult adoptee, or attorney in the presence of a notary public, county clerk, or other person authorized to administer oaths. The application must include a photocopy of the valid photo ID for the person signing.

•The notary public’s signature, seal or stamp, and commission expiration date must be shown in this section.

Page 2 of 4

VS-160 (Rev. 3/22)

IMPORTANT: Photocopies, alterations, strike-through, or write overs in Section 1 through 7 will not be accepted. Please use a new application if you make a mistake. Copies of E-filed Certificates of Adoption will be accepted.

Certificate of Adoption

THIS IS A PERMANENT RECORD. Type or Print (blue or black ink ONLY). Remittance No.___________

Section 1: Birth Certificate Information

Enter information as it appears on the current birth certificate (before this adoption).

Birth Certificate Number, if known: 142 -			-

Child’s First Name:		Middle Name:		Last Name:		Date of Birth (MM/DD/YYYY):			Sex:

Time of Birth:	Name of Hospital/Facility:				City:		County:	State or Foreign Country:

Full Maiden Name (First, Middle, Last) of Parent 1:				Full Maiden Name (First, Middle, Last) of Parent 2:

Section 2: Information for New Birth Certificate

All information below MUST be provided or a new birth certificate cannot be completed.

Is this a Single Parent Adoption? ☐ Yes

☐ No

Parent 1

Title to Appear on Birth Record (check one):

Mother

Father

Parent

Adoptive

First Name:

Middle Name:

Current Last Name:

Maiden Last Name(s) before marriage:

Biological

Date of Birth (MM/DD/YYYY):

Place of Birth

(State or Foreign Country):

Parent 2

Title to Appear on Birth Record (check one):

Mother

Father

Parent

Adoptive

First Name:

Middle Name:

Current Last Name:

Maiden Last Name(s) before marriage:

Biological

Date of Birth (MM/DD/YYYY):

Place of Birth

(State or Foreign Country):

Parent(s) Address

Street Address

City

County

State

Zip

Inside City Limits:

at the time of

Yes No

child’s birth:

Parent(s) Current

Street Address

City

County

State

Zip

Address:

Parent(s) Email Address:

Parent(s) Phone No.:

(

)

Section 3: Parent’s Signature

Parent’s Signature (REQUIRED):

Section 4: Attorney/Placing Agency Information

Name of Attorney of Record:

Attorney’s Email Address:

Attorney’s

Information:

Mailing Address (Street address, City, State, Zip):

Phone No.:

(

)

Placing

Name of Child Placing Agency or Managing Conservator:

Agency or

Managing

Mailing Address (Street address, City, State, Zip):

Phone No.:

Conservator:

(

)

Section 5: Certification of the Court

Please complete the child’s name as set forth in the Decree of Adoption.

Name of the child as set forth in the Adoption Decree:

First

Middle

Last

I hereby certify that the above information is correct as stated in the Decree of Adoption which was granted on _______________

day of ________________________,___________ in the _________________ Court of ________________ County, Texas in

Cause #__________________________.

________________________________________________	[Stamp or Seal]
________________________________________________
District Clerk’s Signature

WARNING: The Penalty for knowingly making a false statement in this form can be 2-10 years in prison and a fine of up to $10,000. (Texas Health and Safety Code, Chapter 195).

Page 3 of 4

VS-160 (Rev. 3/22)

Section 6: What is Your Name? (Applicant’s Information)

Name (First, Middle, Last):

Address (Mailing Address, City, State, Zip):

Email Address:	Telephone # (8am-5pm):	(	)	-

Your relationship to Person named on the birth certificate: ☐ Adoptive Parent ☐ Self ☐ Attorney representing Adoptive Parent(s)

>>>>>>>A COPY OF THE APPLICANT’S VALID PHOTO ID MUST BE ATTACHED<<<<<<<

Section 7: Would the applicant like to order a certified copy of the new birth record?

Check one:
No, I would not like a certified copy of the new birth record.
Yes, I would like a certified copy of the new birth record.	Number ordered: ________

If Yes, verify the fees and quantity ordered in the fee box on Page 1 and mailing address in Section 6. Sign below in the presence of a notary public and ATTACH a copy of your valid Photo ID. Applications without acceptable valid ID attached will not be processed. Cross-outs or white-outs will VOID your application.

WARNING: The Penalty for knowingly making a false statement in this form can be 2-10 years in prison and a fine of up to $10,000. (Texas Health and Safety Code, Chapter 195).

Adoptive Parent, Adult Adoptee, or Attorney	>>>>>ATTACH A COPY OF YOUR VALID PHOTO ID<<<<<

Printed Name:			Signature:

Address:		City:		State:		Zip:

Notary Public, County Clerk, or other person authorized to administer oaths

Sworn to and subscribed before me, this ______ day of ____________ 20______.

Signature:
					[Stamp or Seal]

Printed name and title:

Page 4 of 4

VS-160 (Rev. 3/22)

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Common mistakes

Incomplete Sections: Failing to complete all required sections of the form can lead to processing delays. Each section must be filled out accurately.
Missing Signatures: Not providing the necessary signatures, especially from adoptive parents, will result in the application being rejected.
Invalid Photo ID: Submitting an application without attaching a valid photo ID will prevent processing. The ID must be current and legible.
Incorrect Fees: Failing to include the appropriate fees as outlined in the fee schedule can delay the application. All fees must be paid in full.
Photocopies and Alterations: Submitting photocopies or altering any part of the form will lead to rejection. Original documents are required.
Omitted Certification: Not having Section 5 certified by the clerk of the court can result in the need for additional documentation, which complicates the process.
Incorrect Information: Providing incorrect details about the child or adoptive parents can cause significant delays. Accuracy is essential.
Failure to Follow Mailing Instructions: Not adhering to the specified mailing instructions for regular or expedited service can lead to processing delays.
Not Keeping Copies: Failing to retain copies of submitted documents can create issues if any part of the application needs to be verified or resubmitted.

Key takeaways

When filling out and using the Texas Adoption Papers form, it is essential to follow specific guidelines to ensure a smooth process. Here are five key takeaways:

Eligibility to Apply: The application can be submitted by the person named on the birth certificate (if 18 or older), adoptive parents, their attorney, or district clerks.
Complete and Accurate Information: All sections of the form must be filled out accurately. Incomplete applications will be rejected.
Required Documentation: A valid photo ID must accompany the application. If a district clerk submits the application, a cover letter on official letterhead is required instead of a photo ID.
Submission Guidelines: The application must be original. Photocopies or altered documents will not be accepted. Submit the application along with the required fees to the appropriate address.
Processing Times: Regular processing takes approximately 6-8 weeks, while expedited service can reduce this to 20-25 business days. Ensure to check the latest processing times online.

⇓ Texas Adoption Papers PDF

Steps to Using Texas Adoption Papers

Once you have gathered all necessary documents and information, you can begin filling out the Texas Adoption Papers form. This form is essential for amending a birth certificate following an adoption. Completing it accurately is crucial to avoid delays in processing your application.

Obtain the form: Download the Texas Adoption Papers form from the official website or request a physical copy.
Fill out Section 1: Provide the child’s information as it appears on the current birth certificate. This includes the child's name, date of birth, sex, and place of birth. If the adoption is Texas-based, include the names of the biological parents.
Complete Section 2: Enter the adoptive parents' information. Ensure you do not list a married name as a maiden name. If it’s a step-parent adoption, include the biological parent's details as well.
Sign Section 3: One adoptive parent must sign this section. Incomplete applications will not be processed.
Provide information in Section 4: Include the name, address, and phone number of the attorney or child placing agency, if applicable.
Certification of the Court in Section 5: This must be completed by the court clerk. If this section is not certified, submit a certified copy of the final decree of adoption.
Fill out Section 6: Provide the applicant’s contact information and relationship to the person named on the birth certificate. Remember, district clerks do not need to fill out this section.
Complete Section 7: Indicate whether you would like to order a certified copy of the new birth record. If yes, sign this section in front of a notary public.
Attach required documents: Include a copy of a valid photo ID and any other supporting documents as required.
Submit the application: Mail your completed application, supporting documents, and the appropriate fees to the address specified for regular or expedited service.

After submitting your application, it will be processed, and you can expect a new birth record to be filed with the adoption information. Keep in mind that providing accurate information and all required documents will help ensure a smooth process.