CP&P 24-8
(rev. 10/1982)
State of New Jersey
DEPARTMENT OF CHILDREN AND FAMILIES
Child Protection and Permanency
IN THE MATTER OF THE
ADOPTION OF A CHILD
BY: [Enter adoptive parent(s) name]
DATE: [Enter]
COUNTY: [Enter]
STATEMENT OF COSTS
___________________________________________________________________________
Preliminary Hearing
Actual Costs
$[Enter costs]
Final Hearing
Supervision Costs
$[Enter costs]
Report to Court
$[Enter costs]
Total Expenses incurred
(No. of months x cost per month)
$[Enter costs]
Amount paid (date: [Enter date]
$[Enter amount paid]
Balance due
$[Enter balance due]
___
The amount indicated above represents the total costs incurred to date by Child Protection and
Permanency.
Please note the above fee can be made in installments prior to the Final Hearing date.
Please make the check payable to the STATE OF NEW JERSEY and forward it:
To: [Enter name]
At: [Enter full adress]
Signature of Supervisor
[Enter name of Supervisor]
[Enter title of Supervisor]
[Enter name of Area Office]