חומר רקע

CCI Adoption Agreement Attachment A Guatemala Program A/P has read, understands, and agrees with the program fees as set forth in Attachment A. A/P further understands that all fees are non-refundable except as specified below under the section “Fee refunds.” ALL FEES AND EXPENSES ARE SUBJECT TO CHANGE All fees are subject to change, and are charged at the rate that is current at the time of the signed Agreement with exception of the in-country fee. The in-country fee charged will be the current fee at the time of referral acceptance as determined by the country of adoption. Fees Application fee $ 250.00# CCI Agency fee 4,250.00 Educational adoption toolbox Inc. w/Agency fee Home Study review 100.00* Humanitarian Aid fee 500.00 In-country fee 8,000.00 – 20,000.00/child Change in country fee 1,300.00 In-country foster care (if applicable) 400.00/month Orphanage fees TBD Home Study Fees CCI Home Study 1,400.00† Home Study addendum varies Additional mileage (if required) 0.485/per mile CCI Post adoption fees 200.00 – 250.00/each visit† †This fee is for a home study/post adoption reports completed by CCI. Home studies/post adoptions completed by cooperating agencies are subject to their fees and will be paid directly to that provider. * Waived if Home Study conducted by CCI. #Waived for prior/returning CCI clients. Miscellaneous Fees (Paid directly to applicable entity) Document authentication $ 200.00 – 350.00 Travel Airfare per adult 400.00 – 600.00 Airfare per adopted infant 100.00 Lodging 235.00 – 400.00 Meals 45.00 – 75.00 USCIS fee 670.00 FBI fingerprinting (cost per adult) 80.00 Child’s visa fee 380.00 Note: Travel/other figures are only estimates. We cannot predict or control airline, hotel and governmental entity costs. Payment Schedule for Fees Fees will be billed to the A/P via an emailed “Statement of fees due.” Please be sure to supply an email address to CCI for this purpose and to access the provided email account frequently to ensure timely receipt of these statements. All invoiced fees are due upon receipt. Clients may pay application fee by personal check; cashiers check is appreciated for remaining fees. Unless otherwise indicated, all fees are paid direct to CCI’s accounting department for recording and receipting. Any fee or billing questions may be directed to [email protected] . Application fee Submit with application CCI Agency fee Submit with CCI Adoption Agreement Home Study review fee Submit with CCI Adoption Agreement Educational Adoption Toolbox Submit with CCI Adoption Agreement Humanitarian Aid fee Submit with CCI Adoption Agreement (separate ck) In-country fee Submit ½ upon referral acceptance, remainder at case entry into final court – “PGN” (separate cashier’s cks) Home Study fee Paid at time of home study visit Dossier related fees Paid throughout dossier preparation to the providers of these services. Travel These costs are the responsibility of the adoptive parent(s). In-country foster care In the circumstance that a family accepts a child before their dossier is complete (including notarization, county verification where applicable, state certification and consulate authentication) and/or before the client’s local homeland security office issues approval for the family to adopt internationally, if the dossier/homeland security approval is not in the CCI within three weeks of accepting the referral of a child, the client may be required to pay foster care at the monetary amount that their in-country lawyer/facilitator indicates. Fee refunds • Generally, all application, CCI agency, home study and post placement fees paid to CCI are non-refundable; however, in some circumstance may be applied to future international adoptions with CCI. • There may be extenuating situations in which CCI may consider a partial refund of unused fees.  • Adoption fees are not refundable in the event a family chooses to discontinue an adoption outside of the above timeframe or if CCI terminates the adoption for breach of contract. • If an adoption service is not provided and advance payments were made, parents may be entitled to a refund. These fees will be refunded within 60 days of completion of delivery of services.Fees paid to country cannot be returned. Application Fee: A non-refundable application fee must accompany the Application for Adoption. CCI Agency Fee: Upon application approval, a CCI Agency fee must accompany the International Adoption Services Agreement.  Humanitarian Aid Donation: May be required for some country programs, this fee may be a tax deductible contribution.  The Humanitarian Aid Donation does not count towards the Federal Adoption Credit.  CCI will use this fund to support humanitarian efforts to improve the quality of life for the children in the country who are not being adopted.    In-Country Fee: The country fee is set by the facilitating organizations in each country.  The fee includes background investigation and identification of child, social services, accepting legal responsibility for the child, work with government and agency authorities, legal fees, child care, medical expenses**, and, in some countries, passport and US visa fee’s (refer to individual country fee schedules) in the child’s country.  A portion of this fee must accompany dossier to country for processing.  **Note: Once a case has exited PGN, any medical bills from that point forward, not including the Visa medical visit, are the responsibility of the adoptive parent. Home study Fee: The home study is a comprehensive study and written report that is necessary prior to all agency adoptions.  The home study must be completed by CCI home study provider, or by an approved cooperating agency in the adoptive parent(s) state of residence.  Dossier Related Fees: The dossier is a collection of documents that, along with your home study, will represent you and your family in the country where you choose to adopt.  These fees include those involved with document collection, notarization, state authentication/ verification, foreign country authentication and translation, and postage, overnight and courier fees.  Travel: Travel fees include parent(s) U.S. passport, foreign country entry visas, airfare, hotels, meals, supplies, sightseeing, souvenirs, taxis, and similar costs.   These fees vary according to country, length of time in country, season, and accommodations, and the costs are the responsibility of the parent(s). Post Adoption Fee: This fee is for services after child’s adoption and return home, for a minimum 6 month period.  At least one Supervisory visit, by an agency Social Worker, is required by CCI.  Compliance with this requirement is essential to continuing favorable adoption relations with foreign countries. Country Change Fee: In the event that the families chosen country closes adoptions, the family may choose to wait for the country to re-open or choose another country. If the new chosen country remains with the same program manager there will be no country change fee. If the family voluntarily decides to change another country program and the change necessitates a change in program managers, there will be a country change fee as specified by CCI at that time. Each country change fee is done on a case by case basis.    Fee Reductions: CCI strives to encourage a loving family for ALL children and will consider fee reductions for children with special needs, older children, and large sibling groups.  Each child and family will be considered on an individual basis. CCI’s promise to our client families is to provide the highest quality services to them, and children and families in need, while charging reasonable fees for the services we provide. Unforeseen expenses: CCI does not customarily charge additional fees and expenses beyond those disclosed in the adoption services contract. In the event that unforeseen additional fees and expenses are incurred in the Convention country, CCI charges such additional fees and expenses only under the following conditions: (1) CCI will disclose the fees and expenses in writing to the prospective adoptive parent(s). (2) CCI will obtain the specific consent of the prospective adoptive parent(s) prior to expending any funds in excess of $1000 for which the agency or person will hold the prospective adoptive parent(s) responsible. (3) CCI will provide written receipts to the prospective adoptive parent(s) for fees and expenses paid directly by the agency in a Convention country and retains copies of such receipts for the purpose of being reimbursed by the prospective adoptive parents. Please have your signatures notarized to attest that you agree with the terms of this entire agreement, CCI Adoption Agreement, Attachment A. Adoptive Mother______________________ Adoptive Father________________________ Dated this ____ day of ___________, 20___. STATE OF_________COUNTY OF______________ Sworn to and subscribed before me this ________ day of _______________, 20_____ Notary Public _______________________My commission expires: ________________ Signature as is on stamp Who is personally known to me or produced identification. Type of Identification produced _____________________ Checklist of Required Items Country Specific--Guatemala Items to be returned immediately: Included in the Adoption Agreement electronic file: ___ Adoption Agreement (notarized and each page initialed) NOTARIZED ___ Affidavit of Good Moral Character---His NOTARIZED ___ Affidavit of Good Moral Character---Hers NOTARIZED ___ Affidavit of Good Moral Character Addendum---His NOTARIZED ___ Affidavit of Good Moral Character Addendum---Hers NOTARIZED ___ (If there are others over the age of 18 in your home, an Affidavit of Good Moral Character/addendum is required for each person) NOTARIZED ___ Express Shipping Authorization ___ Release of Confidential Information NOTARIZED Included in the Guatemala Fee Contract electronic file: ___ Fee Contract (Notarized and each page initialed) NOTARIZED ___ Labcorp Form (used to pay DNA when authorization is given) ___ Four original signed, but not dated, G28s BLACK INK ___ Four original signed, but not dated, I600s BLACK INK ___ Communication Guidelines NOTARIZED Items to be returned upon availability: ___ Notarized Home Study ___ A copy of the final medical letter/form used for your dossier---His ___ A copy of the final medical letter/form used for your dossier---Hers ___ Assignments and completed notarized checklist from parental education requirements provided in your educational toolbox ___ Scanned or clean mailed copy of your USCIS approval (I-171-H/I-797-C) ___ A copy of your dossier for file retention Items to be returned upon acceptance of the referral of a child: Included in the Adoption Agreement electronic file: ___ Referral and Medical Disclaimer--Notarized Once your child is home: ___ At least one post-placement report conducted by your home study agency/social worker at or around six months (after placement of the child in the home); OR ___ If your state requires more than one post-placement, a copy of each post-placement conducted by your home-agency/social worker. LabCorp GUATEMALA ADOPTIONS Celebrate Children International 1757 W. Broadway Street Oviedo, FL 32765 CONTACT PERSON: SUE HEDBERG PHONE 407-977-2810 FAX TO: 407-977-2811 Name of Birth Mother: ______________________________________________________ Name of Child: ______________________________________________________ Adoptive Parents Name: ______________________________________________________ Address: ______________________________________________________ Phone: ______________________________________________________ Master Card _____ Visa ______ Discover ____American Express____ Card # __________________________________ Exp. Date: __________ I HEREBY AUTHORIZE LABCORP TO BILL THE CREDIT CARD LISTED ABOVE FOR THE FOLLOWING AMOUNT: $470.00 Print Name: ______________________________________________________ Signature:________________________________________________________ Communication Guidelines Dear Adoptive Parent, The international adoption process requires flexibility and patience. CCI understands the importance for families to receive regular updates on the status of their adoption case. CCI understands families appreciate current, valid information regarding the process and status of their case. Please review the communication guidelines below. CCI believes the guidelines will create a streamlined process for updating individual cases. CCI will make diligent efforts to inform families throughout the adoption journey. Our responsibilities: • Your Guatemalan Case Manager (GCM) will make every attempt to update you once a week on the status of your case, even if the status has not changed (often case updates will be provided Friday or over the weekend); • CCI or your GCM will notify family via e-mail as soon as CCI knows your case has entered PGN, exited PGN, or the pink slip has been issued; • Your GCM will contact your family with any problems in the case which would require your attention (re-doing documents, submitting additional documents, etc); • Your GCM will inform you if there are concerns about your case or referral that CCI deems necessary or helpful to you; • CCI will inform families with regard to changes in the general adoption process in country (slow downs, new procedures, etc); • Your GCM will answer reasonable questions and requests in a timely manner. Client responsibilities: • Treat all agency staff, in-country contacts, and other professionals involved in the adoption process professionally and with respect; • Understand your case is one of many cases in process. While each case is equally important to us, some cases require more attention than others. Each case is attended to as necessary for that individual case. Often it is the case that requires less specific attention that proceeds the fastest; • Address questions and concerns to one CCI staff member only (primarily your GCM). Addressing questions and concerns to multiple staff members consumes additional time and prevents efficiency. • Check your e-mail regularly for updates/information on your case (please attempt to maintain the same e-mail address throughout your adoption process); • Decline sharing dossier lists, client area usernames/passwords, or other confidential information with non-CCI clients. CCI is dedicated to each client and all of the children we serve. CCI enjoys speaking with our clients and assisting them in their adoption journey. CCI holds the best interests of the child as paramount in our operations. Clients who become abusive or disrespectful to agency staff, in-country contacts or other professionals involved in the adoption process may cause CCI to re-evaluate their file or contact the applicable home study agency to determine whether it is in the best interest of the child(ren) for the adoption to continue. Finally, we encourage adoptive families to join our CCI Yahoo group and to join our twice-weekly chats. Updates on the general adoption process are often first discussed through these resources. Sincerely, Sue Hedberg, M.A. Executive Director ________________________________ _________________________________ Adoptive Father’s Signature Adoptive Mother’s Signature ________________________________ Date of Signatures Please provide the following letter to your home study provider: Dear Social Worker: Regarding Hague Home Study Requirement 95.47 (a)-5, the following information is intended to assist you in determining if the prospective adoptive parent’s eligibility to adopt from the country of interest: Guatemala has no eligibility requirements beyond those required by USCIS. Given this fact, the following statement can be included in the home study to meet 95.47 (a)-5: Guatemala does not have any specific adoption requirements beyond what the United States requires of adoptive parents. Issuance of USCIS approval indicates the prospective adoptive parents have met United States adoption requirements. Thank you, Sue Hedberg Guatemala Program Coordinator You will need to send four G-28s and four I-600s. Original printouts with original signatures are required on each. THEY MUST BE SIGNED IN BLACK INK. It is best to fill them out before printing and sign in black ink. If you hand-fill them out, you MUST do everything in BLACK. (SAMPLES ARE BELOW TO HELP) Please press control and right click over the links below to be directed to the forms also needed for processing your Guatemala Adoption PRINT 4 COPIES OF EACH. INSTRUCTIONS FOR G-28 http://uscis.gov/graphics/formsfee/forms/files/g-28.pdf Complete the second block only which contains the name and address information. Sign but do not date the form. ONLY ONE PARENT IS THE PETITIONER and this is the parent listed as petitioner on your I-600a application for USCIS approval or the actual approval itself (I-171-H or I-797-C). For the petitioner, on the first available name and address fields, list the petitioner and check the “Petitioner” box. Do not check any boxes for the non-petitioner, but DO list their name and address in the second available name and address fields. INSTRUCTIONS FOR I600 http://uscis.gov/graphics/formsfee/forms/files/i-600.pdf Complete block one only, sign but do not date the form .