Adopt Adoption Forms Details

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QuestionAnswer
Form NameForm Adopt 200
Form Length5 pages
Fillable?Yes
Fillable fields161
Avg. time to fill out33 min 31 sec
Other namesadoption forms california, adopt adoption forms, form adopt, adoption adopting request

Form Preview Example

Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Clerk stamps date here when form is filed.

ADOPT-200 Adoption Request

If you are adopting more than one child, fill out an adoption request for each child.

1Your name(s) (adopting parent(s)): a.

b.

Relationship to child: Street address:

City:

 

State:

 

Zip:

 

 

Fill in court name and street address:

 

 

 

 

 

 

 

 

 

 

Telephone number:

Lawyer (if any): (Name, address, telephone numbers, e-mail address, and State Bar number):

2I/We filed this Adoption Request in this court because it is in the county (check all that apply):

Where the adopting parent(s) live;

Where the child was born or where the child now lives;

Where an office of the agency that placed the child for adoption is located;

Where an office of the department or public adoption agency that is investigating the petition is located;

Where a placing birth parent or parents lived when the adoptive placement agreement, consent, or relinquishment was signed;

Where a placing birth parent or parents live(s) when the petition was filed; Where the child was freed for adoption.

(If the child is a dependent of the court, the Adoption Request must be filed in the county where the child was freed for adoption or the county where the adopting parent(s) reside(s). See Fam. Code, § 8714.)

3 Type of adoption (check one):

 

(To be completed by the clerk of the superior court

Agency (name):

 

 

if a hearing date is available.)

 

 

 

 

 

 

 

 

 

 

Relative

Nonrelative

 

Hearing is set for:

 

 

Joinder will be filed.

Joinder is being filed at

Hearing

Date:

 

 

Date

 

 

 

 

 

same time as this Adoption Request.

Time:

 

 

 

 

 

 

 

 

 

Dept.:

Room:

Tribal customary adoption

 

 

 

 

 

 

 

 

 

 

Name and address of court if different from above:

(attach tribal customary adoption order)

 

 

 

 

 

 

Independent

 

 

 

Relative

Nonrelative

Additional Parent(s)

 

To the person served with this request: If you do

Intercountry (name of agency):

 

not come to this hearing, the judge can order the

 

 

adoption without your input.

This adoption may be subject to the Hague Adoption Convention (form ADOPT-216 must be filed with this request).

Judicial Council of California, www.courts.ca.gov Revised January 1, 2018, Mandatory Form

Family Code, §§ 170–180, 7822, 7892.5, 8601.5, 8604, 8606, 8700, 8714, 8714.5, 8802, 8900–8905, 8908–8912, 8919, 8924, 8925, 9000, 9000.5, 9001, 9002, 9208;

Welfare and Institutions Code, §§ 366.24, 16119; Cal. Rules of Court, rules 5.480–5.487, 5.730

Adoption Request

ADOPT-200, Page 1 of 5

b. Father:

Your name:

Case Number:

3

Stepparent

Stepparent adoption to confirm parentage. (Select this option if you were married to or in a state-registered domestic partnership with the birth parent at the time the child was born and you remain in that union.)

4Information about the child

a.

The child’s new name will be:

 

 

 

 

 

e.

Place of birth (if known):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

b.

Boy

Girl

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State:

Country:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c.

Date of birth:

 

 

 

 

Age:

 

 

 

f.

If the child is 12 or older, does the child agree to

 

 

d.

Child’s address (if different from yours):

 

 

 

 

the adoption?

Yes

No

 

 

 

Street:

 

 

 

 

 

 

 

 

 

 

g. Date child was placed in your physical care:

 

 

 

City:

 

State:

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5Child’s name before adoption (Fill out ONLY if this is an independent, stepparent, or tribal customary adoption):

6 Does the child have a legal guardian?

Yes

No

(If yes, attach a copy of the Letters of Guardianship and fill out below):

a.Date guardianship ordered:

b.County:

c.Case number:

7

Is the child a dependent of the court?

Yes

No

 

(If yes, fill out below):

 

 

 

 

Juvenile case number:

 

 

 

 

 

County:

 

 

 

 

8

Child may have Indian ancestry:

Yes

No

a.Whether you answered “Yes” or “No,” you must fill out and attach Indian Child Inquiry Attachment (form ICWA-010(A)) and Parental Notification of Indian Status (form ICWA-020) or other proof that ICWA inquiry has been completed in accordance with rule 5.481(a).

b.If you answered “Yes,” you must also fill out and attach Adoption of Indian Child (form ADOPT-220) if, after notice, it is determined that ICWA does apply to the child.

9Names of birth parents, if known:

a. Mother:

10If this is an agency adoption:

a.I/We have received information about the Adoption Assistance Program, the Regional Center, mental health services available through Medi-Cal or other programs, and federal and state tax credits that might be available. Yes No

b.All persons with parental rights agree that the child should be placed for adoption by the California Department of Social Services or a county adoption agency or a licensed adoption agency (Fam. Code, § 8700) and have signed a relinquishment form approved by the California Department of Social Services, and the time to revoke

the relinquishment has expired or been waived.

Yes No (If no, list the name and relationship to child of each person who has not signed the relinquishment form or whose time to revoke the relinquishment has not expired or been waived):

Revised January 1, 2018

Adoption Request

ADOPT-200, Page 2 of 5

Your name:

Case Number:

10c. This is a tribal customary adoption under Welfare and Institutions Code section 366.24. Parental rights have been modified under and in accordance with the attached tribal customary adoption order, and the child has been ordered placed for adoption. Yes No

d.This is an adoption conducted under the requirements of the Hague Adoption Convention and the child will be moving or has already moved with the adopting parent(s) to another Hague Convention member country at the

conclusion of this adoption.

Yes

No If yes, child will be moving or has moved to (name of country):

 

 

and adopting parent(s)

seek(s) a California adoption

will be petitioning for a Hague Adoption Certificate

will be seeking a Hague Custody Declaration.

11

12

13

14

If this is an independent adoption:

a.

A copy of the Independent Adoptive Placement Agreement from the California Department of Social Services is

 

attached. (This is required in most independent adoptions; see Fam. Code, § 8802.)

Yes

 

No

b.

All persons with parental rights agree to the adoption and have signed the Independent Adoptive Placement

 

Agreement or consent on the appropriate California Department of Social Services form.

Yes

No

 

(If no, list the name and relationship to child of each person who has not signed the agreement form):

c. I/We will file promptly with the department or delegated county adoption agency the information required by the department in the investigation of the proposed adoption. Yes No

d. This is an independent adoption involving additional parent(s): All persons with existing parental rights agree to this adoption and will maintain their existing parental rights. An agreement waiving termination of parental rights, signed by both the existing parent(s) and the adopting parent(s) is attached.

If this is a stepparent adoption:

 

 

 

a.

The birth parent (name):

 

 

has signed a consent

will sign a consent.

b.

The birth parent (name):

 

 

has signed a consent

will sign a consent.

c.

The adopting parents were married on or The domestic partnership was registered on

 

 

(date):

 

. (For court use only. This does not affect social worker’s recommendation.

 

There is no waiting period.)

 

 

 

d. I am seeking a stepparent adoption to confirm my parentage. At the time the child was born, I was married to or in a state-registered domestic partnership with the parent who gave birth and we remain in that union.

See attached

form ADOPT-205 or

declaration describing the circumstances of the child’s conception.

e.Completing the investigation or written report (Choose one)

I will choose someone to do an investigation or written report. I understand that the person I choose must be a licensed clinical social worker, a licensed marriage and family therapist, or work for a licensed private adoption agency. I will pay this person or agency directly.

I would like the court to choose someone to do an investigation. I understand that the court can charge me money for this investigation.

The child was conceived by assisted reproduction in compliance with Family Code section 7613.

Contact after adoption

Contact After Adoption Agreement (form ADOPT-310)

is attached

will not be used

will be filed at least 30 days before the adoption hearing

is undecided at this time.

This is a tribal customary adoption. Postadoption contact is governed by the attached tribal customary adoption order.

15Consent for adoption is not necessary because (complete all sections that apply to your adoption):

a.

 

The consent of the

birth parent

presumed father

is not necessary because

(check the applicable reasons under Fam. Code, § 8606):

 

(1)

The parent has been judicially deprived of the custody and control of the child.

Revised January 1, 2018

Adoption Request

ADOPT-200, Page 3 of 5

Your name:

Case Number:

15a. (2) The parent has voluntarily surrendered the right to custody and control of the child in a judicial proceeding in another jurisdiction, under a law of that jurisdiction providing for the surrender.

(3) The parent has deserted the child without providing information to identify the child.

(4) The parent has relinquished the child under Family Code section 8700.

(5) The parent has relinquished the child for adoption to a licensed or authorized child-placing agency in another jurisdiction.

b.

A court ended the parental rights of:

 

 

 

 

Name:

 

Relationship to child:

 

on (date):

 

 

 

 

 

 

 

 

Name:

 

Relationship to child:

 

on (date):

 

 

 

 

 

 

 

 

(Enter the date of the court order ending parental rights and attach a copy of the order.)

c.

The child is the subject of a tribal customary adoption order under Welfare and Institutions Code section

 

366.24, which has modified the parental rights of:

 

 

 

 

Name:

 

Relationship to child:

 

on (date):

 

 

Name:

 

Relationship to child:

 

on (date):

 

 

Name:

 

Relationship to child:

 

on (date):

 

 

 

 

 

 

 

 

(Attach a copy of the order.)

 

 

 

 

d. I/We will ask the court to end the parental rights of (attach copy of Petition to Terminate Parental Rights or Application for Freedom From Parental Custody, if filed):

Name:

 

Relationship to child:

Name:

 

Relationship to child:

e. Adopting parent has custody of the child by court order or by agreement with the other parent, and each of the following persons with parental rights has not contacted the child and has not paid for the child’s care, support, and education for one year or more when able to do so. (Fam. Code, § 8604(b).)

Name:

 

Relationship to child:

Name:

 

Relationship to child:

Name:

 

Relationship to child:

f.

g.

The child has been abandoned as follows:

(1) The child has been left by the child’s parent or parents with no way to identify the child.

(2) The child has been left in the custody of another person by both parents or the sole parent for six months without providing for the child’s support, or without communication from the parent or parents, with the intent to abandon the child.

(3) One parent has left the child in the care and custody of the other parent for one year or longer without providing for the child’s support or without communication from the parent, with the intent to abandon the child.

(If any of the above boxes are checked, adopting parent must also check item 15(d) and file an Application for Freedom From Parental Custody. See Fam. Code, § 7822(a).)

The consent of the presumed father is not required because he did not become a presumed father before the mother’s relinquishment or consent became irrevocable or the mother’s parental rights were terminated. (Fam. Code, § 8604(a).)

Revised January 1, 2018

Adoption Request

ADOPT-200, Page 4 of 5

Your name:

Case Number:

15h. Each of the following persons with parental rights has died:

Name:

 

Relationship to child:

Name:

 

Relationship to child:

16Suitability for adoption Each adopting parent:

a.

Is at least 10 years older than the child or

c.

Will support and care for the child;

 

meets the criteria in Family Code section

d. Has a suitable home for the child; and

 

8601(b);

e.

Agrees to adopt the child.

b.

Will treat the child as his or her own;

 

 

17

18

I/We ask the court to approve the adoption and to declare that the adopting parents and the child have the legal relationship of parent and child, with all the rights and duties of this relationship, including the right of inheritance.

I/We ask the court to date its order approving the adoption as of an earlier date (date): for the following reason (Fam. Code, § 8601.5):

(Enter a date no earlier than the date parental rights were ended.)

This is a tribal customary adoption. I/We ask the court to approve the adoption and to declare that the adopting parents and the child have the legal relationship of parent and child, with all of the rights and duties stated in the attached tribal customary adoption order and in accordance with Welfare and Institutions Code section 366.24.

If a lawyer is representing you in this case, he or she must sign here:

Date:

Type or print lawyer’s name

Signature of lawyer for adopting parent(s)

19I declare under penalty of perjury under the laws of the State of California that the information in this form and all its attachments is true and correct to my knowledge. This means that if I lie on this form, I am guilty of a crime.

Date:

 

 

 

 

 

 

 

Signature of adopting parent

 

 

 

Type or print your name

 

Date:

 

 

 

 

 

 

 

 

 

 

 

Type or print your name

Signature of adopting parent

NOTICE—ACCESS TO AFFORDABLE HEALTH INSURANCE: Do you or someone in your household need affordable health insurance? If so, you should apply for Covered California. Covered California can help reduce the cost you pay toward high-quality affordable health care. For more information, visit www.coveredca.com. Or call Covered California at 1-800-300-1506 (English) or 1-800-300-0213 (Spanish).

Revised January 1, 2018

Adoption Request

ADOPT-200, Page 5 of 5

How to Edit Form Adopt 200

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entering details in adoption forms request stage 1

Fill in the Type of adoption (check one):, Agency (name):, Relative, Nonrelative, Joinder will be filed, Joinder is being filed at, Independent, (To be completed by the clerk of, Hearing is set for:, Hearing, Date, Date: Time: Dept, Room:, Name and address of court if, and Relative section with the particulars asked by the platform.

Completing adoption forms request stage 2

Write down the essential particulars in Your name:, Case Number:, Stepparent, Stepparent adoption to confirm, Information about the child a, The child’s new name will be:, Boy, Girl, Date of birth: Child’s address (if, State:, Zip:, Age:, Place of birth (if known):, City: State: If the child is 12 or, and Country: segment.

Finishing adoption forms request step 3

The Does the child have a legal, Date guardianship ordered: County:, Is the child a dependent of the, Yes, Juvenile case number: County:, Child may have Indian ancestry: a, Yes, Whether you answered “Yes” or, If you answered “Yes, Names of birth parents, Mother:, Father:, If this is an agency adoption: a, I/We have received information, and Yes section will be applied to write down the rights or obligations of both parties.

stage 4 to entering details in adoption forms request

Look at the fields All persons with parental rights, Revised January 1, Adoption Request, and ADOPT-200 and then complete them.

Filling in adoption forms request stage 5

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