APPLICATION FOR SURRENDER OF CHILD

 from:bhlakshmidcpovzm@gmail.com] 

Sent: Sat, September 8, 2016 10:02 AM
To: helpap@gmail.com

Respected Sir,

Please give details on ‘Application for Surrender of Child?

Thanking you,

 Your’s sincerely,  

Bh.Lakshmi

DCPO -DCPU ,

Vizainagaram  district.  

     Thank u respected lakshmi garu please give bellow application for Surrender of Child as per JJ CENTRAL RULES .                                                           

FORM 23

[Rule 19(22)]

APPLICATION FOR SURRENDER OF CHILD

Date ……….

To

Child Welfare Committee,

District……………….

I/ We………………(name of the applicant/s) …………….(relation with the child)

of……………….(name of the child), aged about……….years , intend to surrender…………………..name of

child)beforethisChildWelfareCommittee as……………………………………………………….(reason/s for surrender).

I/we am /are fully conscious and making this application before this Child Welfare Committee. I have not been forced or unduly influenced by any one to take this decision of Surrendering……………………. (name of child). I shall have no objection if the child is given in adoption. Iam fully aware of the consequences of surrendering the child.

Full signature of the applicant(s)/

Thumb impression (if the CWC deems appropriate)

Name and address.

…………………………….

(Signature of the Chairperson/ member

Before whom such application is submitted)

Committee member/s present:____________________

Date…………………..

Time……………………

Place…………………..