________ (person's name) is notified that a petition for adoption of a child, named __________ (child's name, if named), born to __________ (mother's name) on __________ (date) was filed in the office of the clerk of __________ court, __________ (address of the court). The petition for adoption alleges that the consent to adoption of __________ (person's name) is not required because _________________________ (provide a brief description of the reason(s) the consent is not required).
    If __________ (person's name) seeks to contest the adoption of the child, __________ (person's name) must file a motion to contest the adoption in accordance with IC 31-19-10-1 in the above named court not later than thirty (30) days after the date of service of this notice.
    If __________ (person's name) does not file a motion to contest the adoption within thirty (30) days after service of this notice the above named court will hear and determine the petition for adoption. The consent to adoption of __________ (person's name) will be irrevocably implied and __________ (person's name) will lose the

right to contest either the adoption or the validity of __________'s (person's name) implied consent to the adoption.
    No oral statement made to __________ (person's name) relieves __________ (person's name) of __________'s (person's name) obligations under this notice.
    This notice complies with IC 31-19-4.5-3 but does not exhaustively set forth a person's legal obligations under the Indiana adoption statutes. A person being served with this notice should consult the Indiana adoption statutes.".
As added by P.L.61-2003, SEC.10.

IC 31-19-4.5-4
Waiver of notice
    31-19-4.5-4 Sec. 4. (a) The notice required by this chapter may be waived in writing before or after the birth of a child.
    (b) A waiver of notice under subsection (a) must:
        (1) be in writing and signed in the presence of a notary public; and
        (2) acknowledge that:
            (A) the waiver is irrevocable; and
            (B) the person signing the waiver will not receive notice of the adoption proceedings.
A person who waives notice of an adoption may not challenge or contest an adoption of the child.
As added by P.L.61-2003, SEC.10. Amended by P.L.130-2005, SEC.3.

IC 31-19-4.5-5
Content of notice
    31-19-4.5-5 Sec. 5. The description in the notice under section 3 of this chapter of the reasons consent to adoption is not required need only include enough information to put a reasonable person on notice that a petition for adoption that alleges the person's consent to adoption is unnecessary is pending. The description does not require an exhaustive description of the reasons the person's consent to adoption is not required.
As added by P.L.61-2003, SEC.10.