Pennsylvania Adoption Information Registry Adoptee Authorization and Registration Form (CY 911)
Pennsylvania Department of Human ServicesAdoptionForm CY 911Free downloadLast verified November 10, 2026
Lets an adoptee, or the adoptive parent of a minor adoptee, register information with the Pennsylvania Adoption Information Registry and choose whether identifying information may be released. It goes to the registry at the Department of Human Services, not the vital records office.
Who can use this form
- An adoptee who is at least 18
- An adoptive parent of an adoptee under 18
What to send with it
- Completed form, typed or printed in black or blue ink
- Signature of the adoptee or adoptive parent on the form
Where to send it
- Mail to
- Pennsylvania Adoption Information Registry P.O. Box 959 Camp Hill, PA 17001-0959
- State fee
- Not provided
- Typical processing
- Not provided
- Issued by
- Pennsylvania Department of Human Services
- Form revision
- 4/24
- Source
- Official government page