F110[1. Information about the child.

(1) Personal public service number of child.

(2) Date and country of birth of child.

(3) Sex of child.

(4) Forename(s) and surname of child.

2. Information about the person who is (i) married to or (ii) in a civil partnership with or (iii) cohabiting with the adopter (if any).

(1) Forename(s), surname, birth surname, address and occupation.

(2) Former surname(s) (if any).

(3) Date of birth.

(4) Civil status.

(5) Personal public service number.

3. Information about the adopter or adopters.

(1) Forename(s), surname, birth surname, address and occupation.

(2) Former surname(s) (if any).

(3) Date of birth.

(4) Civil status.

(5) Personal public service number.

4. Information about previous adoption (if any).

(1) Date of previous adoption.

(2) Country of previous adoption.

(3) Reference number from relevant adoption register.

5. Other information.

(1) Date of adoption order.

(2) Date of registration.

(3) Signature of an tArd-Chláraitheoir or an officer of an tArd-Chláraitheoir duly authorised by him or her.]