(a)    for every search in the index of the Adopted Children Register kept by the Registrar-General

Shs. 1,000.00

    (b)    for every certified copy of any entry in the Adopted Children Register

Shs. 2,000.00

    In the matter of the Adoption of Children Act, and in the matter of A.B. (name of child) of (address).

    The petition of C.D. of (address) [and E.D. his wife, of the same address] showeth–

    1. Your Petitioner(s) is (are) desirous of adopting the said A.B. under the provisions of the Adoption of Children Act.

    2. Your Petitioner(s) is (are) resident at …………………………………………………………………
in ……………………………………………………………….. Tanzania.

    3. Your Petitioner C.D. is unmarried (was married to your Petitioner E.D., at ………………….
…………………………………….. on the ……………………. day of ……………………………)

    4. Your Petitioner C.D. is by occupation a …………………………………………………………..

    5. Your Petitioner C.D. is ………………… years of age (and your Petitioner E.D. is ………………… years of age).

    6. Your Petitioner(s) has (have) resident with them the following persons, namely: (X.D. son aged ………………… years, Y.D. daughter aged ………………… years).

    7. Your Petitioner C.D. (E.D) is related to the said A.B. as follows:

    …………………………………………………………………… or, Your Petitioner(s) is not (are not nor is either of them) related to the said A.B.

    8. The said A.B. is–

    (a)    of the …………………………… sex;

    (b)    unmarried;

    (c)    a child of ………………………………………………………………………………………….. of
(address) and ……………………………………………………………………………………….
of (address)

    (d)    a British subject;

    (e)    ………………… years of age, having been born at …………………………………………..
on ……………………………….;

    (f)    resident at ………………………………………………………………………………………….;

    (g)    now in the actual custody of …………………………………………………………………….
of ………………………………………………………………………………………… (address);

    (h)    under the guardianship of …………………………………………………………………………
of ………………………………………………………………………………………… (address);

    (i)    is entitled to the following property, namely: …………………………………………………
…………………………………………………………………………………………………………

    9. ………………………………………………………………………………………………………….. of
(address) ………………………………………………………………………………………………….. (and
………………………………………………………………………………………………………………….. of
………………………………………………………………………………….. …………………………..) are
liable to contribute to the support of the said A.B.

    10. The said A.B. has not been the subject of an adoption order or of an application or petition for an adoption order except that (state order and application or petition, if any).

    11. Your Petitioner(s) undertakes (undertake), if this petition is granted, to make the following provision for the said A.B., namely:

    Your Petitioner(s) will, if required, secure the above provision by bond or otherwise as the Court may require.

    12. Consents to this petition have been obtained from the following persons, namely:

    (a)    Parents of child;

    (b)    Guardian;

    (c)    Person having actual custody of child;

    (d)    Person or persons liable to contribute to support of child;

    (e)    Spouse of Petitioner.

    13. Your Petitioner(s) has not (have not nor has either of them) received or agreed to receive and no person has made or given or agreed to make or give to the Petitioner(s) (or either of them) any payment or reward in consideration of the adoption of the said A.B. (except as follows: ………………………………………………………..).

    14. It is proposed that the costs of this petition shall be paid by …………………………. Your Petitioner(s) prays (pray)–

    (a)    that an order for the adoption of the said A.B. by your Petitioner(s) may be made in pursuance of the Adoption of Children Act with all necessary directions;

    (b)    that the costs of this petition may be provided for as above-mentioned or otherwise as the Court may direct;

    (c)    such further or other order as the nature of the case may require.

    Note: It is intended to serve this petition on ……………………………………………………….

    In the matter of a Petition by …………………………………………………………………………. of
…………………………………………………………………………………………………. for an Order for
Adoption of ………………………………………………………. the said child

    I, the undersigned ……………………………………………………………………………………….. of
……………………………………………………………………………………………………………. being–

     function a4(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (a)    the father of the said child;

     function a5(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (b)    the mother of the said child;

     function a6(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (c)    guardian of the said child;

     function a7(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (d)    a person having the actual custody of the said child;

     function a8(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (e)    a person liable to contribute to the support of the said child;

     function a9(msg) { myWindow=window.open(”,”,’width=234,height=99,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}* (f)    the spouse of the petitioner,

hereby state that I understand the nature and effect of the adoption order for which application is made [and that in particular I understand that the effect of the order will be permanently to deprive me of my parental rights]. And I hereby consent to the making of an adoption order in favour of the petitioner(s).

    In witness whereof I have signed this consent on the ……………………. day of ……………………. 20…….., at …………………………………………………….

(Signature) ………………………………………………….

    Signed by the said ……………………………………………………………… in my presence after
I had explained the meaning and effect of this consent and of an adoption order to him (her) and he (she) appeared to understand the same.

        (Signature of witness) ……………………………………………………………………………………….

        (Address) ………………………………………………………………………………………………………..
………………………………………………………………………………………………………..
………………………………………………………………………………………………………..

        (Description) ………………………………………………………………………………………………………..
………………………………………………………………………………………………………..
………………………………………………………………………………………………………..

To. ……………………………………………………………………………………………………………… of
……………………………………………………………………………………………………………………..

    Take notice that a Petition has been presented in the above matter praying that an order may be made for the adoption of the above-named ……………………………………………………..
…………………………………………….. by …………………………………………………………………..
of ……………………………………………………………………………………………………….. and that
…………………………………………………………………………………………………………………… of
………………………………………………………………………………………………………………… has
been appointed guardian ad litem to the said child and that the said Petition will be heard by the Court at …………… on the ……………………. day of ……………………. at ………………….
o’clock in the ……………… noon.

………………………………………………………..
Registrar

Upon reading the petition of …………………………………………………………………………… [and
………………………………………………………………………………………….] and upon reading the
affidavits of ………………………………………………………………………………………………… and
…………………………………………………………………………………………………………… and the
exhibits thereto (refer to the affidavit filed in the matter and the exhibits thereto) and upon hearing …………………………………………………………… and the evidence of (state names and addresses of witnesses examined orally);

    And the Court being satisfied that the allegations in the said Petition are true and being also satisfied with the undertaking of the said …………………………………………………………………
and ……………………………………………………………….. as to the provision to be made for the above-named child and with the securing thereof and being further satisfied that it is for the benefit of the said child that he/she should be adopted by the said …………………………………
………………………………… and ………………………………………………………………………… and that all the requirements of the Adoption of Children Act have been complied with;

    It is ordered that the said ……………………………………………………………………………….
[and …………………………………………………………………….] be authorised to adopt the said
child.

    [And the following payment or reward is sanctioned, namely– …………………………………..].

    And it is ordered that the parties to these proceedings other than the said ……………………
……………………………………………………… [and ………………………………………………………]
do recover their costs against the said …………………………………………………………………….
[and ……………………………………………………….], such costs to be taxed by the Registrar,
and it is ordered that the said ……………………………………………………………………….. [and
…………………………………………………………………….] do pay the amount of the said costs when taxed to the Registrar of this Court within fourteen days after the date of the certificate of taxation.

    And it is directed that the Registrar-General shall make an entry recording this adoption in the Adopted Children Register in the Form set out in the Schedule to the said Act.

    [And it having been proved to the satisfaction of the Court that the said child was born on the ……………………. day of ……………………. 20…….. and is identical with ………………………….
…………………………………………… to whom an entry numbered ……………………………. and
made on the ……………………. day of ……………………. 20…….. in the Register of Births for
the registration district of …………………………………. relates, it is further directed that the Registrar-General shall cause such birth entry or entries to be marked with the word “Adopted” and shall include the above date of birth in the entry recording the adoption in the manner indicated in the Schedule to the said Act.

Upon reading, etc,}

As in Adoption Order)

And upon reading, etc,}

And upon hearing, etc,}

And the evidence, etc,}

    And the Court being satisfied that the allegations in the said Petition are true and also being satisfied with the undertaking of the said …………………………………………………………………
[and ………………………………………………………………………..] as to the provision to be made
for the above-named child and with the security thereof and being further satisfied that it is for the benefit of the said child that he/she should for the present be in the custody of the said ……………………………………………………………. [and …………………………………………………] function a10(msg) { myWindow=window.open(”,”,’width=234,height=76,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}<a href="javascript:void()" style="color:#FF0000;" onclick="a10('Guardian ad litem.’)”>* and that all the requirements of the Adoption of Children Act have been complied with;

    The following payment or reward is sanctioned, namely–
…………………………………………………………………………………………………………………

    And it is ordered that determination of the Petition be postponed and that the custody of the said child be given to the said …………………………………………………………………….. [and
…………………………………… …………………………] for the period of ………………………. from the date of this order by way of a probationary period [and subject to the supervision of function a11(msg) { myWindow=window.open(”,”,’width=233,height=82,left=400 ,scrollbars=1,top=400,screenX=400,screenY=100′);myWindow.document.write(msg);}<a href="javascript:void()" style="color:#FF0000;" onclick="a11('Guardian ad litem‘)”>+…………………………………………… of ……………………………………………………………………
who shall be at liberty at all reasonable times to visit and interview the child alone and to make all necessary inquiries as to the comfort and well-being of the child).

    And as regards costs it is ordered that ………………………………………………………………

    And any of the parties including the guardian ad litem of the said child are to be at liberty to apply as they may be advised.

    I, ……………………………………………………………………………………………………………., of
……………………………………………………………………………………, Christian (Moslem, Hindu,
Pagan), make oath (solemnly affirm) and say as follows:

    1. The matters stated in paragraphs 1 to 7 of the Petition are true and I know the same of my own knowledge except that as regards my own age (and the age of the petitioner E.D.) I refer to the birth certificate(s) attached hereto. I also refer to the certificate of my marriage attached hereto.

    2. The matters stated in paragraph 8(a), (b), (f) and (g) of the Petition are true and I know the same of my own knowledge. My knowledge of the matters stated in paragraph 8(c), (d), (e), (h) and (i) of the Petition is derived from information supplied to me by ………………………………………………………………………………………………………………… of
…………………………………………………………………………………………………………….. and I
believe the same to be true. I refer to the birth certificate of the said A.B. attached hereto.

    3. My knowledge of the matter contained in paragraph 9 of the Petition is derived from information supplied to me by ……………………………………………………………………………….
of ……………………………………………………………………………………………………………. and I
believe the same to be true.

    4. The matter contained in paragraph 10 of the petition is true to the best of my knowledge, information and belief.

    5. The matters contained in paragraphs 12 and 13 of the Petition are true and I know the same of my own knowledge. I beg to refer to the consents of (a) ……………………………………
and …………………………………… (parents), (b) ………………………………………….. (guardian),
(c) …………………………………………………….. (actual custodian of child), (d) …………………..
…………………………………………………….. (person or persons liable to contribute to support of child), (e) ………………………………………………………. (spouse of petitioner) attached hereto.