LIST OF DOCUMENTS

The following documents are required to be produced in original along

with a copy (1+1) by the PAPs:-
1 Proof of date of birth of the parents (Birth Certificate (or) School
Certificate of both the applicants (Husband and Wife).
2 Marriage Certificate
(Registered in Government Marriage Registered Office).
3 Income Certificate (If the PAPs (Husband and Wife) are self-employed - IT
statement for the last three years and if they are employed,
Income Certificate from the employer or income certificate issued by
Govt. department –Current )
4 Health certificate by a registered medical practitioner certifying that the
PAPs (Husband and Wife) are not suffering from any contagious or
terminal disease or any mental or physical condition, which may prevent
them from taking care of the child. Individually for both Parents.
And current HIV report for them (Husband and Wife) individually.
5 Reference letters from two persons who know the PAPs (Husband and
Wife) well with ID. Such recommendation should not be from immediate
relatives of either spouse.
6 Family Photograph
(Five recent postcard sized photographs of the adoptive family).
7 Undertaking letter from brother or sister of the PAPs (Husband and Wife)
stating that in the event of any unforeseen circumstance, they would take
care of the child with ID (Husband and Wife).
8 Proof of identity for PAPs (Husband and Wife) (voter card or pan card or
passport or driving license).
9 Proof of address indicating residence in India exceeding 365 days
(Aadhar card/ Voter ID card/ Passport).
10 Financial Statement including copies of bank statement for the last six
months, details of movable and immovable property owned by the PAPs
and details of loans taken by the PAPs (Husband and Wife).

11 PAN card of the PAPs

12 Original Home Study Report.
 UNDERTAKING LETTER

From

Mr./Mrs.
Mr./Mrs.

Mobile No:

To
The Director,
Specialised Adoption Agency,
Nirmala Orphanage and Rehabilitation Center,
Kovilur(Vill), Nallampalli(Po),
Dharmapuri(Dt), Tamil Nadu, Pin-636807.

Respected Sir / Madam,

Mr./Mrs. residing at____________________ is my
. Mr./Mrs. is my
. They do not have child till date. We assure you that they will
take good care of the child they adopt and ensure its safety. In case anything happens to both of
them in future, we assure you that we will take responsibility for the child they adopt and will
care for the child to the best of our abilities.

Thank You
Yours Sincerely,

1.
( )

2.
( )
 REFERENCE LETTER

From

Mr./Mrs.

Mobile No:

To
The Director,
Specialised Adoption Agency,
Nirmala Orphanage and Rehabilitation Center,
Kovilur(Vill), Nallampalli(Po),
Dharmapuri(Dt), Tamil Nadu, Pin-636807.

Respected Sir / Madam,

I have known Mr. and Mrs. residing

at very well for the past
years. It has come to my attention that they don’t have child yet and expressed their
willingness to adopt a child. I am giving my unequivocal support to them as prospective parents who have
all the qualities and responsibilities in raising the child.

Therefore, kindly considering them for adopting a child from your esteemed organization.

Thank You
Yours Sincerely,

(________________________)
 HEALTH CERTIFICATE

In my professional judgment on the basis of a through examination, I hereby certify

that Mr. / Mrs. _______________________________, aged ______ years, is in good

physical and mental health, is free of any chronic disease, is free of any serious infectious

disease.

Height – _______ cm. Vision –

Weight – _______ kg. Hearing –

Chest Measurements: Cardio Vascular System –

(i) on full inspiration – ……….cm. Respiratory System –

(ii) on full expiration – ……….cm. Immunisation Status–

Blood Group –

Blood Pressure –

Blood : Haemoglobin –

Urine : Albumin –

Sugar –

Deposit –

Identification Marks : 1.

2.

He / She is not suffer from any chronic, contagious or fatal disease and they are fit to adopt.

Place :

Date : Doctor’s Signature