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To__________Adoption Organization,


      Through the examination of the basic condition of the adoptive families and their plan of treatment and rehabilitation for the child ____________from____________welfare institute, it is agreed that the adoption will be carried out through the procedure for adopting children of special needs after the submission of application documents of the adopters according to their wish.




(Sealed) Administration Department,


                                              China Center of Adoption Affairs

                                                                Month      Day     Year



(China-ccaa.org October 16, 2006)

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