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By CDSS, or notarized by a Notary Public.* If the signing of this form is witnessed by a CDSS or adoption agency representative, photo identification of the person signing must be obtained and noted on this form. THIS FORM WILL BE RETURNED TO YOU IF IT IS NOT WITNESSED OR NOTARIZED PART A. DESIGNATE ONE: I am the Birth Parent Adult Adoptee (age 18 or older) To be completed by person signing consent BIRTH PARENT: By signing this form, I voluntarily give my consent to the CDSS.

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