Adoption Agreement

							COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No.

ADOPT-210
1 1
a. b.

Adoption Agreement
Plaintiff(s)

Clerk stamps date here when form is filed.

: : :

Your names (adopting parents):

-against-

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Relationship to child: : Your address (skip this if you have a lawyer): : Street: State: Zip: City: Defendant(s) : .Your . . . . . .number:.(. . . . ). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . phone . . . . . . Your lawyer (if you have one): (Name, address, phone number, and State Bar number):

Fill in court name and street address:

Superior Court of California, County of

THE PEOPLE OF THE STATE OF NEW YORK TO
2 Child’s name: Before adoption: GREETINGS: After adoption:
Fill in case number:

Case Number:

3

Date of birth: COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Age: WE , the Honorable at the Court I am the child listed in 2 and I agree to the adoption. located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Date: or adjourned date, to testify and give evidence as a witness in this action on the part of the Type or print your name Signature of Child (child must sign at hearing if 12 or older; optional if child is under 12) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. If only one adopting parent, read and sign below: a. I am the adopting parent listed in 1 , and I agree that the child will: Witness, Honorable , one of the Justices of the (1) Be adopted and treated as my legal child (Fam. Code, § 8612(b)); and Court in County, day of , 20 (2) Have the same rights as a natural child of mine, including the right of inheritance. Date: Type or print your name
(Attorney must sign above and type name below)

4

Signature of Adopting Parent (sign at hearing)

Attorney(s) for b. I am the spouse or state-registered domestic partner of the adopting parent listed in 1 , and I agree to his or her adoption of the child.
Date: Type or print your name

Office and P.O. Address
Signature of Spouse or State-Registered Domestic Partner Telephone No.: Facsimile No.: E-Mail Address: ADOPT-210, Page 1 of 2 Adoption Agreement Mobile Tel. No.:
American LegalNet, Inc. www.USCourtForms.com

Judicial Council of California, www.courtinfo.ca.gov Revised January 1, 2006, Mandatory Form Family Code, §§ 8602–8606, 8612, 9003; Cal. Rules of Court, rule 1464

Case Number:

Your name:
6 5 If two adopting parents, read and sign below: We are the adopting parents listed in 1 , and we agree that the child will: (1) Be adopted and treated as our legal child (Fam. Code, § 8612(b)); (2) Have the same rights as a natural child of ours, including the right of inheritance;

and I agree to the other parent’s adoption of the child. Date: Type or print your name and I agree to the other parent’s adoption of the child. Date: Type or print your name Signature of Adopting Parent (sign at hearing) Signature of Adopting Parent (sign at hearing)

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For stepparent/domestic partner adoptions only: If you are the legal parent of the child listed in 2 , read and sign below: I am the legal parent of the child and the spouse or state-registered domestic partner of the adopting parent listed in 1 , and I agree to his or her adoption of my child. Date: Type or print your name Signature of Legal Parent (sign at hearing)

7

Executed: Date:

Judge (or Judicial Officer)

Revised January 1, 2006

Adoption Agreement
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ADOPT-210, Page 2 of 2

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