A. The notice of filing of a mother's intent to surrender for adoption shall contain the following information in substantially the following form:
"NOTICE OF FILING OF ACT OF INTENT TO SURRENDER
FOR ADOPTION
Be advised that on the _________ day of ______________, 20__, ____________ (MOTHER'S NAME) voluntarily filed an act of intent to surrender for adoption of her minor child, namely ____________, born on the ______ day of ____________, 20__, in the Parish/County of _____________, State of _____________.
OR
[Be advised that on the ___________ day of ____________, 20___, ________________(MOTHER'S NAME) voluntarily filed an act of intent to surrender for adoption of her expected child to be born on or about _______________, 20__.]
The act of intent to surrender for adoption names you as the father of this child. The act of intent to surrender for adoption does not bind the mother to follow through with plans to surrender her child for adoption. She may change her mind. Its only purpose is to determine whether you will oppose plans for surrendering this child for adoption.
You may attempt to oppose the proposed adoption of this child only by filing a written objection with this court within fifteen days after you receive this notice. In your objection, you must provide the court with an address where you can be contacted about further proceedings, if any, regarding the child's adoption.
A form for your use is attached.
Note that this objection must be signed under oath before a notary public after you have proved your identity. If the objection does not have the notary's signature, it is not effective.
If you do file such a written objection:
(1) You will have the right to receive notice of any surrender for adoption that the mother may hereafter sign giving up her parental rights to the child.
(2) You will also have the right to be given notice of any hearing scheduled by the court to decide whether your parental rights should be terminated. At that hearing, you must show that you are claiming or have acknowledged paternity of the child and must prove that you have assumed parental responsibility for the child, that you are a fit parent, and that you are willing and able to take custody of the child. At that hearing, the court will decide whether your efforts have been sufficient to preserve your parental rights regarding this child and to prevent the child's adoption.
These notices will be served upon you at the address you provide in your written objection.
If you do not file a written, notarized objection within fifteen days from the time you receive this notice, then you waive notice and service of future surrender or adoption proceedings, you have no cause of action to challenge the child's adoption, and all rights you may have as the child's alleged father may be terminated by order of this court and the child may be adopted if the mother does decide to sign a surrender of the child for adoption.
These are serious consequences. You are urged to contact a lawyer to advise you further."
B. With every notice of the filing of an act of intent to surrender for adoption, this form must be included for the alleged father's use:
"OBJECTION TO ADOPTION
____________ (Court File #)
STATE OF LOUISIANA
PARISH OF (NAME OF PARISH)
I, __________________________ (FATHER'S NAME), have received notice of an act of intent to surrender for adoption filed by ___________________________ (NAME OF PREGNANT FEMALE OR MOTHER), which names me as the father.
I believe that I am the father of this child.
I object to any adoption of this child.
I can be reached for notification of any surrender for adoption executed by the mother and any hearing on my opposition to the adoption of this child at
_______________________________________________________
(ADDRESS: STREET, CITY AND ZIP CODE).
I understand that all notices will be made at that address unless I notify the court listed below in writing of a different address. If I move without notifying the court, I understand that the court will rule that no further attempts need to be made to contact me about any adoption of this child.
__________________________
(SIGNATURE)
___________________________
(PRINT NAME)
SWORN TO AND SUBSCRIBED BEFORE ME, Notary, on this the ________ day of ____________, _______, at ___________________ (CITY), Louisiana.
___________________________
NOTARY PUBLIC AND SEAL
In order to be effective, this objection must either be mailed by registered or certified mail or filed by you or your representative with the following court:
JUVENILE COURT OF ____________ PARISH
(Address)"
Acts 2003, No. 564, §1.