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Termination Order (Voluntary Relinquishment) - Pennsylvania
Termination Order (Voluntary Relinquishment) Form. This is a
Pennsylvania form and can be used in Orphans Court Westmoreland
Local County .  Fillable pdf Last Modified 4/2/2014 Get this
form for FREE as a print-only pdf  IN THE COURT OF COMMON PLEAS
OF WESTMORELAND COUNTY, PA ORPHANS' COURT DIVISION IN RE:
ADOPTION OF : (Adoptee's name as on birth certificate) : : : :
No: ATTORNEY: TERMINATION ORDER (Voluntary Relinquishment) AND
NOW, this ________ day of _______________, 20 , after review of
the record and after an evidentiary hearing following due
notice, the Court makes the following findings and judicial
determination. 1. 2. 3. The Petitioner(s) is/are . The
Petitioner(s) is/are the natural parent(s) of the above
captioned ADOPTEE. The Petitioner(s) has/have knowingly,
deliberately and voluntarily relinquished all of his/her/their
parental rights to the ADOPTEE. 4. ALL OF THE PETITIONER