Vs 44 Form PDF Details

The VS 44 form, or the Court Report of Adoption, plays a pivotal role in the adoption process in California, bearing the weight of finalizing the legal relationship between adoptive parents and their child. This comprehensive document not only facilitates the sealing of the original birth certificate but also paves the way for the creation of a new certificate of birth, reflecting the child's new legal guardianship status. The form demands precise and clear information, strictly prohibiting any form of alteration or misuse such as erasures, whiteouts, or photocopies, and mandates the use of black ink for completion. The first part requires details pertinent to the child's identity and birth information as recorded originally, while the second part calls for adoptive parents to provide their personal details as they were at the child's birth date. This information is instrumental in crafting a new birth certificate, should the adoptive parents choose to have one established, marking a significant step in acknowledging the adoptive relationship legally. Additionally, the document delves into options about retaining or omitting certain information from the new birth certificate, thereby giving adoptive parents a say in the level of privacy or disclosure they prefer in this legal document. Moreover, the filing process, overseen by the court clerk and necessitating the involvement of an agency or department responsible for handling the adoption, ensures that the document meets all legal requirements set forth by the California Department of Public Health - Vital Records. This meticulous procedure underscores the VS 44 form's critical function in affirming the new familial bonds legally recognized by the state, embodying more than a mere formality but a heartfelt acknowledgment of a newly formed family unit.

QuestionAnswer
Form NameVs 44 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescalifornia vs44, form vs 44, court report of adoption vs 44, vs44 form

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COURT REPORT OF ADOPTION

___________________________

NO ERASURES, WHITEOUTS, PHOTOCOPIES,

___________________________

 

 

 

STATE FILE NUMBER

OR ALTERATIONS

LOCAL REGISTRATION NUMBER

 

 

 

 

TYPE OR PRINT CLEARLY IN BLACK INK ONLY

 

 

 

 

 

 

 

 

PART I

 

The information provided in this section must be the information as it was at birth. Without this data, it may be

 

 

 

 

impossible to prepare a new Certificate of Birth.

 

 

 

 

 

 

 

 

 

FACTS

OF

BIRTH

PARENTS’

DATA

1A. NAME OF CHILD—FIRST

 

1B. MIDDLE

1C. LAST (BIRTH)

 

2. SEX

3. DATE OF BIRTH—MM/DD/CCYY

4. NAME OF PHYSICIAN (OR ATTENDANT, CERTIFIER, OR OTHER PERSON WHO ATTENDED THIS BIRTH)

5A. PLACE OF BIRTH—NAME OF HOSPITAL OR FACILITY

 

5B. CITY

 

5C. STATE OR COUNTRY

 

 

 

 

 

6D.RELATIONSHIP

6A. FULL NAME OF PARENT—FIRST

 

6B. MIDDLE

6C. LAST (BIRTH)

 

MOTHER

 

 

 

 

 

 

 

 

 

 

FATHER

 

 

 

 

 

PARENT

7A. FULL NAME OF PARENT—FIRST

 

7B. MIDDLE

7C. LAST (BIRTH)

7D.RELATIONSHIP

 

MOTHER

 

 

 

 

 

 

 

 

 

 

FATHER

 

 

 

 

 

PARENT

 

PART II

Adoptive parents must furnish personal information about themselves as it was on the child’s date of birth. This

 

 

information is used to prepare the new Certificate of Birth.

 

 

 

 

 

 

 

 

 

 

 

 

CHECK THE APPROPRIATE BOX: ADOPTIVE PARENT

□

BIOLOGICAL PARENT □

 

 

PARENT

8A. NAME OF PARENT—FIRST

8B. MIDDLE

 

 

 

 

8C. LAST (BIRTH)

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. DATE OF BIRTH—MM/DD/CCYY

 

 

9. STATE/FOREIGN COUNTRY OF BIRTH

 

 

 

 

 

 

CHECK THE APPROPRIATE BOX: ADOPTIVE PARENT

□

 

BIOLOGICAL PARENT □

 

 

PARENT

11A. NAME OF PARENT—FIRST

11B. MIDDLE

 

 

 

 

11C. LAST (BIRTH)

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. DATE OF BIRTH—MM/DD/CCYY

 

 

12. STATE/FOREIGN COUNTRY OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

14. PLEASE CHECK ONE

 

 

 

□

15. Do you want the name of the hospital or other facility where birth occurred

 

I want the original birth certificate sealed, and a new birth certificate established

 

omitted from the new birth certificate as provided for in Section 102645 of the

 

 

Health and Safety Code? (PLEASE CHECK ONE)

 

 

 

 

 

 

 

 

Pursuant to Health and Safety Code Section 102640, I choose not to have a new birth

 

 

□

YES □

NO □

 

certificate established

. .

 

 

VERIFICATION

16. SIGNATURE OF PARENT VERIFYING DATA IN PART II

17. MAILING ADDRESS OF PARENT VERIFYING DATA IN PART II

 

 

 

 

 

 

 

 

 

 

OF PART II

►

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENCY OR

18A. NAME OF AGENCY OR DEPARTMENT

 

18B. MAILING ADDRESS OF AGENCY/DEPARTMENT THAT INVESTIGATED/HANDLED THE ADOPTION

 

 

 

 

 

 

 

 

 

 

DEPARTMENT

 

 

 

 

 

 

 

 

 

 

19A. SIGNATURE AND PRINTED NAME OF ATTORNEY

 

19B. MAILING ADDRESS OF ATTORNEY

 

ATTORNEY

►

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART III

The court clerk must obtain as much information as is available to complete Parts I and II before completing Part III

 

 

and forwarding the record and Court Order/Final Decree to the State Registrar as required by law.

 

 

 

 

 

 

 

 

 

 

20.I HEREBY CERTIFY THAT THE INDIVIDUAL DESCRIBED ABOVE WAS ADOPTED BY THE ABOVE NAMED ADOPTIVE PARENTS ON THE __________________________ DAY OF _____________________________, 20________, AS SET FORTH IN THE DECREE OF ADOPTION MADE ON THAT DATE IN CASE NUMBER _____________________________

21A. NEW NAME AS SET FORTH IN THE DECREE OF

21B. MIDDLE

21C. LAST

ADOPTION - FIRST

 

 

COURT

 

 

 

 

CLERK

 

 

 

 

 

22. SIGNATURE AND SEAL OF COURT CLERK

BY:

 

 

 

►

 

 

 

 

23. CLERK IN AND FOR THE COUNTY OF:

24. DATE SIGNED—MM/DD/CCYY

25. DATE PETITION FOR ADOPTION FILED—MM/DD/CCYY

 

NAME

 

 

 

NAME AND

 

 

 

 

MAILING ADRESS

 

 

 

 

OF PERSON TO

ADDRESS—Street and Number

CITY, STATE, ZIP CODE

DAYTIME TELEPHONE NUMBER

WHOM CERTIFIED

 

 

 

 

COPY IS TO BE

 

 

(

)

SENT

 

 

 

 

 

 

STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH - VITAL RECORDS

 

FORM VS 44 (Rev. 1/16)

GENERAL INFORMATION

The Court Clerk shall complete and transmit a court report of adoption to CDPH - Vital Records for each decree of adoption granted by any court in the State of California.

CDPH - Vital Records shall transmit court reports of adoptions for births that occurred in another state, the District of Columbia, any territory of the United States, or Canada to the appropriate registration authority.

The information contained in Part I and Part II of this certificate is required in order to identify and seal the original birth certificate and prepare a new birth certificate. Once the original birth certificate is sealed, it is only available upon order of a Superior Court.

INSTRUCTIONS

The agency or department handling the adoption should fill out Parts I and II, but the Court Clerk may complete any incomplete items in Part I or Part II from the information furnished in the court record.

When requested by the adoptive parents, the CDPH - Vital Records shall NOT establish a new birth certificate for the child. (Health & Safety Code Section 102640.) The adoptive parents should indicate in Item

14 whether they DO want a new birth certificate established (by checking the “Yes” Box) or whether they DO NOT want a new birth certificate established (by checking the “No” Box).

The adoptive parents may request CDPH – Vital Records to omit the specific name and address of the hospital or other facility where the birth occurred by checking the “Yes” Box in Item 15. (Health & Safety Code

Section 102645.)

A deceased spouse of an adopting single parent can be listed on the new birth certificate if both adopting parents were in the home at the time of the initial placement of the child for adoption. Refer to Health & Safety Code Section 102660 for additional requirements.

One of the adopting parents should verify the information in Part II, sign in Item 16, and enter his or her mailing address in Item 17. The name and address of the agency or department and the attorney handling the adoption should be entered in Items 18 and 19.

The applicable fee shall be paid to the Court Clerk at the time of filing the petition in an adoption proceeding for the services required by statute of the State Registrar. (Health & Safety Code Section 103730.)

For cases in which the petition for adoption was filed on or after January 1, 1972, and the individual was

born in California or a foreign country, a certified copy of the new birth record will be furnished without additional fee as provided in Health & Safety Code Section 102710.

For adoptions that occurred prior to January 1, 1972, or in another state, a fee must be submitted for processing the new birth certificate, which includes one certified copy.

Additional certified copies may be obtained from CDPH – Vital Records, but there is an additional fee for each additional certified copy requested. Please contact CDPH – Vital Records for the current fees, or visit our website at www.cdph.ca.gov. Please do not order additional copies until you have reviewed the original copy for accuracy. The mailing address for CDPH – Vital Records is:

California Department of Public Health – Vital Records

MS 5103

P.O. Box 997410

Sacramento, CA 95899-7410

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Writing part 1 of court report of adoption

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PARENT, Pursuant to Health and Safety Code, and I want the original birth of court report of adoption

3. This next section is all about CLERK IN AND FOR THE COUNTY OF, DATE SIGNEDMMDDCCYY, DATE PETITION FOR ADOPTION, NAME, ADDRESSStreet and Number, CITY STATE ZIP CODE, DAYTIME TELEPHONE NUMBER, NAME AND, MAILING ADRESS OF PERSON TO, WHOM CERTIFIED, COPY IS TO BE, SENT, STATE OF CALIFORNIA DEPARTMENT OF, and FORM VS Rev - type in each of these blank fields.

The best way to prepare court report of adoption part 3

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