I hereby certify that Shri X…………., son of Y…………., resident of………………….. visited this……………….Orphanage on……………………. and desired to adopt a male child from the orphanage, as his son.

After looking at many children in the orphanage, Shri X…………. selected A……………., the names of whose parents are not known. The marks of identification on the body of the boy are as under

At the request of Shri X……….., I enquired from Shri A……….. about his willingness to be adopted by Shri X……… who has expressed his willingness to be adopted by Shn X………. I applied to the…………….. court for…………….
Permission of the said adoption and the……………………. court vide its order dated……………………. permitted the adoption and appointed me as the guardian of A……….. for the purposes of giving the said A………… in adoption. I confirm that I have given Shri A…. in adoption and Shri X……….. has taken him in adoption on……………………. along with the Datta Homam and other religious ceremonies in the presence of relatives and friends of Shri X…………

I am satisfied myself that the adoption will be in the interest and for the welfare of the A…… . I also hereby certify that to my knowledge there is no other person who has ever claimed to be the guardian or relative of the said Shri A………..

Place:…………….. ……………………………………

Date:…………… Superintendent Orphanage