The petition for the voluntary termination of parental rights under this chapter shall be verified and contain the:

1. (1) Name and place of residence of the petitioner or petitioners;
2. (2) Name, sex, race, citizenship, and date of birth of the child;
3. (3) Relationship of the petitioner or petitioners to the child;
4. (4) Name, address, race, religion, and citizenship of the parent or parents of the child;
5. (5) Reasons for desiring the termination of parental rights;
6. (6) Name and address of the person or persons or of the authorized agency to whom or to which parental rights are sought to be transferred;
7. (7) Consent of the petitioner or petitioners to the termination of parental rights;
8. (8) Consent executed by the person or persons or authorized agency to whom or to which parental rights are to be transferred;
9. (9) Statement that no temporary assistance for needy families benefits were ever received on behalf of the minor child from the State of South Dakota or any other state.

Source: SL 1971, ch 165 , § 5; SL 1973, ch 163 , § 3; SL 1995, ch 143 , § 3.