Follow the steps to complete the H105 091 Rev 4 04 form online

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. In Part I, enter the name of the child before adoption in the designated field.
3. Provide the name of the biological father as required in the next input section.
4. Enter the maiden name of the biological mother in the appropriate field.
5. Complete the place of birth by filling in the city, borough or township, county, and state.
6. Indicate the child's full name and date of birth, providing the month, day, and year as specified.
7. Provide information about the adoptive parents, starting with the full name and Social Security number of the adoptive father.
8. Fill in the birthplace and age of the adoptive father at the time of the child’s birth, as well as the child’s sex.
9. Repeat the same steps for the adoptive mother, including the full maiden name and Social Security number.
10. Identify the prior relationship each adoptive parent had to the child by checking the appropriate boxes.
11. Complete the adoptive parents' mailing address as of the time of adoption.
12. Note if this is a single-parent adoption by selecting 'Yes' or 'No'.
13. In Part III, provide the name, address, and telephone number of the attorney handling the adoption.
14. In Part IV, certify the information by filling out the adoption date, the name the child will bear post-adoption, and case number as applicable.
15. Determine if the adoption is based on a foreign decree by indicating 'Yes' or 'No'.
16. Finally, make sure all fields are completed accurately before saving your changes.
17. You can then download, print, or share the completed form as necessary.

Start filling out your H105 091 Rev 4 04 form online today!