Expenditures. A. The Disclosure Statement of Adoption-related Costs and Expenditures required by Section 7505-3.2 of Title 10 of the Oklahoma Statutes shall be in substantially the following form: DISCLOSURE STATEMENT OF ADOPTION-RELATED COSTS AND EXPENDITURES The following is a declaration of all fees, expenses, and costs charged or expected to be charged for the adoption: 1. Retainer fees in the amount of ______________________; 2. The hourly billing rate of _____________________ and the number of hours billed for the adoption _____________________ for a total amount of ____________________; 3. All fees charged for preplacement or other home studies of any prospective birth parents, regardless of whether the study was performed by a third-party ___________________; 4. All costs, fees, or expenses or any other thing of value paid to or on behalf of the birth parents related to the adoption by any party other than the adoptive parents __________________________ _______________________________________________________________; and 5. Any other fees and expenses related to the adoption not previously listed in this disclosure statement _____________________ __________________________________________________________________. B. The Disclosure Statement of Adoption-related Costs and Expenditures that shall be filed with the court clerk and available for public inspection shall include the following: "I, ____________________, Judge of the District Court in and for _________________ County, State of Oklahoma, a Court having original adoption jurisdiction, do hereby certify that upon this day, ________________, the disclosures contained in this disclosure statement are consistent with the sealed disclosure statement filed in the adoption case."
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