| SL.NO.
|
Particulars |
Prospective Adoptive Father |
Prospective Adoptive Mother |
| 1
|
Name |
|
|
| 2 |
Date of Birth (Proof Required) |
|
|
| 3 |
Place of Birth (Proof Required) |
|
|
| 4 |
Nationality (Copy of passport required) |
|
|
| 5 |
Religion/community |
|
|
| 6 |
Roots/moorings in India (Proof Required) |
|
|
| 7 |
Permanent residential address |
|
|
| 8 |
Present/habitual residential address |
|
|
| 9 |
Education |
|
|
| 10 |
Occupation |
|
|
| 11 |
Employment particulars (To be enclosed) |
|
|
| 12 |
Annual Income(To be enclosed) |
|
|
| 13 |
Date of marriage |
|
|
| 14 |
Relation with the Biological parents of the child |
|
|
| 15 |
Particulars of biological children (if any) name, sex & age |
|
|
| 16 |
Whether the PAPs are eligible to adopt the proposed child as per the Law of the Country of their habitual residence? |
|
|
| 17 |
Whether the PAPs are entitled (as per their nationality/residence/ immigration status) to take the child to the Receiving Country |
|
|
| 18 |
Name of the person, his/her designation and his agency/organization, who has completed the HSR |
|
| 19 |
Date of completion of HSR |
|