43-146.07. Biological parent; nonconsent form.
The nonconsent form provided for in section 43-146.06 shall be designed by the department and shall contain the following information:
(1) The name of the person completing the form and, if different, the name of such person at the time of birth of the adopted person;
(2) The relationship of the person to the adopted person;
(3) The date of birth of the adopted person;
(4) The sex of the adopted person;
(5) The place of birth of the adopted person;
(6) A statement that no information contained in the original birth certificate or any other identifying information, except medical histories as provided in section 43-107, shall be released prior to the death of the parent signing the form;
(7) A statement that the person signing understands the effect and consequences of filing or not filing a nonconsent form; and
(8) A notice in the following form:
IMPORTANT NOTICE
You do not have to sign this form. If you do sign it, you are entitled to a copy of it. Your signature on this form means that the Department of Health and Human Services will not disclose any information contained in the original birth certificate of the adopted person or any other identifying information to any person prior to your death without a court order. If you later decide that you do not object to the release of such information, you may file a form stating that purpose.
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