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Sample CPR - the Leicester City, Leicestershire and Rutland ...

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Form <strong>CPR</strong><br />

Part A – Essential Information<br />

Birth fa<strong>the</strong>r with parental responsibility for <strong>the</strong> child<br />

How did he acquire parental responsibility for this child? (Please indicate)<br />

By marriage to <strong>the</strong> birth mo<strong>the</strong>r (before Yes<br />

or after <strong>the</strong> birth)<br />

Registration on <strong>the</strong> birth certificate (only<br />

after 1 December 2003)<br />

Parental responsibility agreement with<br />

birth mo<strong>the</strong>r – section 4 CA 1989<br />

Parental responsibility order – section 4<br />

CA 1989<br />

Does he know of <strong>the</strong> plan to place <strong>the</strong> child for adoption?<br />

Yes<br />

Has he given formal consent to <strong>the</strong> placement of <strong>the</strong> child for adoption<br />

(witnessed by a CAFCASS officer)?<br />

No<br />

Has he given advanced consent to <strong>the</strong> making of an adoption order<br />

(witnessed by a CAFCASS officer)?<br />

No<br />

If he has given advanced consent, has he also given notice that he does<br />

not wish to be notified of <strong>the</strong> application for an adoption order?<br />

Not applicable.<br />

Page 29<br />

© BAAF 2006<br />

All rights reserved. Except as permitted under <strong>the</strong> Copyright, Designs <strong>and</strong> Patents Act 1988, this form may not be<br />

reproduced, stored in a retrieval system, or transmitted in any form or by any means, without <strong>the</strong> prior written permission<br />

of <strong>the</strong> publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.<br />

Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

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