Adoptee Sample Letter Requesting Non-Identifying Information, (NON-ID)

Date and name of agency
Address of agency
City, state, zip code

Subject: Request for nonidentifying info

Reference:
Your adoptive name
date of birth
place of birth date and county
approx. date/county of finalization
your adoptive parents full names

Please send me nonidentifying information on my birth-parents. I am interested in their ages, states of birth, usual residences at the time of my birth, religion, occupation, physical descriptions and medical background of parents. As well as grandparents, do I have any biological siblings and if so, what are their sexes and ages? Were my birth-parents married, and if so when and where. I would also like to know the circumstances of my relinquishment.  .

Have either of my birth-parents or my siblings contacted your agency about me? Have they completed a "Consent" form? Please mail me a consent form I can complete so it can be placed in my file.

Sincerely,
your name
address
city, state, zip code
telephone number

**must be notarized**