Adoption Forms

• ICPC-100A Interstate Compact on the Placement of Children Request
  (ICPC-100A Microsoft Word 334 KB) (ICPC-100A Adobe PDF 235 KB)
• ICPC-100B Interstate Compact on the Placement of Children Report on Childs Placement Status
  (ICPC-100B Microsoft Word 204 KB) (ICPC-100B Adobe PDF 50 KB)
• LDSS-0570 Adoptive Placement Agreement
  (LDSS-0570 Microsoft Word 48 KB) (LDSS-0570 Adobe PDF 45 KB)
• LDSS-0570S Acuerdo de Colocacion Adoptiva
  (LDSS-0570S Microsoft Word 50 KB) (LDSS-0570S Adobe PDF 45 KB)
• LDSS-0571 Medical Report of Prospective Adoptive Parent
  (LDSS-0571 Microsoft Word 69 KB) (LDSS-0571 Adobe PDF 40 KB)
• LDSS-0857 Application to Adopt Part I Family Adoption Registry Information
  (LDSS-0857 Microsoft Word 266 KB)
• LDSS-2724 Notice of Intent to Claim Paternity of a Child Born Out of Wedlock
  (LDSS-2724 Microsoft Word 38 KB) (LDSS-2724 Adobe PDF 23 KB)
• LDSS-2724S Notificacion del Intento de Demandar la Paternidad de un Nino(a) Nacido Fuera del Matrimonio
  (LDSS-2724S Microsoft Word 38 KB) (LDSS-2724S Adobe PDF 15 KB)
• LDSS-2725 Request-Response for Name and-or Address of Father of Child Born Out of Wedlock
  (LDSS-2725 Microsoft Word 58 KB) (LDSS-2725 Adobe PDF 33 KB)
• LDSS-2726 Court Determination of Parentage
  (LDSS-2726 Microsoft Word 142 KB) (LDSS-2726 Adobe PDF 107 KB)
• LDSS-3912 Adoption Assistance Eligibility Checklist
  (LDSS-3912 Adobe PDF 33 KB)
• LDSS-4291 Adoption Fee Disclosure Statement
  (LDSS-4291 Microsoft Word 96 KB) (LDSS-4291 Adobe PDF 68 KB)
• LDSS-4623 Adoption Subsidy Agreement And Non-Recurring Adoption Expenses Agreement - Cover Sheet
  (LDSS-4623 Microsoft Word 80 KB) (LDSS-4623 Adobe PDF 24 KB)
• LDSS-4623A Adoption Subsidy and Non-Recurring Adoption Expenses Agreement - Initial Application
  (LDSS-4623A Microsoft Word 204 KB) (LDSS-4623A Adobe PDF 111 KB)
• LDSS-4623B Adoption Subsidy and Non-Recuring Adoption Expenses Agreement - Post Fianalization Application
  (LDSS-4623B Microsoft Word 199 KB) (LDSS-4623B Adobe PDF 109 KB)
• LDSS-4623C-1 Adoption Subsidy and Non-Recurring Adoption Expenses Agreement - Technical Amendment
  (LDSS-4623C-1 Microsoft Word 62 KB) (LDSS-4623C-1 Adobe PDF 29 KB)
• LDSS-4623C-2 Adoption Subsidy and Non-Recurring Adotion Expenses Agreement - Upgrade or Substantive Amendment
  (LDSS-4623C-2 Microsoft Word 150 KB) (LDSS-4623C-2 Adobe PDF 66 KB)
• LDSS-4623D Adoption Subsidy and Non-Recurring Adoption Expenses Agreement - Non-Recurring Adoption Expenses Reimbursement Form
  (LDSS-4623D Microsoft Word 72 KB) (LDSS-4623D Adobe PDF 23 KB)
• OCFS-3780 Instrument to Acknowledge Paternity of an Out-of-Wedlock Child
  (OCFS-3780 Microsoft Word 57 KB) (OCFS-3780 Adobe PDF 74 KB)
• OCFS-3780S Escritura para Reconocer la Paternidad de un Hijo(a) Natural (Nacido Fuera de Matrimonio)
  (OCFS-3780S Microsoft Word 58 KB) (OCFS-3780S Adobe PDF 75 KB)
• OCFS-4732 Information on Foster Placements of Children Adopted from Other Countries
  (OCFS-4732 Microsoft Word 64 KB) (OCFS-4732 Adobe PDF 76 KB)
• OCFS-4930ASFA Request for NYS Fingerprinting Services - Information Form
  (OCFS-4930ASFA Microsoft Word 76 KB)
• OCFS-4930ASFA-S Solicitud de Servicios de Impresiones Digitales - Formulario Informativo
  (OCFS-4930ASFA-S Microsoft Word 70 KB)
• OCFS-7060 Declaration of Intent to Adopt
  (OCFS-7060 Microsoft Word 36 KB) (OCFS-7060 Adobe PDF 9 KB)
• OCFS-7069 Parental Certification of Continued Support and Educational Status of Child
  (OCFS-7069 Microsoft Word 80 KB) (OCFS-7069 Adobe PDF 14 KB)
• OCFS-LDSS-7015 Amendment to a Fully Executed and Approved Adoption Subsidy Agreement
  (OCFS-LDSS-7015 Microsoft Word 42 KB) (OCFS-LDSS-7015 Adobe PDF 32 KB)
• OCFS-LDSS-7031 Transmittal for Parent Locator Service Search
  (OCFS-LDSS-7031 Microsoft Word 58 KB) (OCFS-LDSS-7031 Adobe PDF 17 KB)
• Judicial Surrenders
• Voluntary Placement Agreement (Model Form)

Order Hard Copies of Forms

To order hard copies of available forms developed by the New York State Office of Children and Family Services (OCFS), complete the "Request for Forms and Publications" form (OCFS-4627) Microsoft Word - OCFS-4627 / Adobe PDF - OCFS-4627 and mail your request to:

OCFS Resource Distribution Center
11, 4th Ave
Rensselaer, NY 12144-2629
OR
Call the Forms Hotline: 518-473-0971