IN RE: ADMINISTRATIVE ORDER 1993-5 -- TERMINATION OF PARENTAL RIGHTS NOTICE FROM THE COURT
ORDER OF COURT
AND NOW, this 2nd day of September, 1993, IT IS HEREBY ORDERED that the Clerk of Orphans' Court shall affix a copy of the attached Notice to each Decree of Termination of Parental Rights and provide a copy of the Notice, along with the Decree, to a parent whose rights have been terminated by the Decree.
BY THE COURT,
Robert A. Freedberg, P.J.
NOTICE FROM THE COURT
Your parental rights have been terminated by decree of this Court. A copy of the Decree of Termination is attached to this Notice. You may at any time place on file with this Court and with the Department of Health of the Commonwealth of Pennsylvania a consent form granting permission for the Court or the Department to disclose the information contained on the child's original certificate of birth, or any other identifying or non identifying information pertaining to you at any time after the child attains the age of eighteen or, if less than eighteen, to his adoptive parent or legal guardian. If both natural parents give their consent, the information on the birth certificate may be disclosed. If only one natural parent gives consent, only the identity of the consenting natural parent shall be disclosed. The natural parents shall be entitled to update those records, as necessary, to reflect the natural parents' current address or any other information pertaining to the natural parents. You may withdraw your consent at any time by filing a withdrawal of consent form with the Court and the Department of Health.