(Court use only) Petition to Obtain Information From Superior Court Adoption File-Interested Party Family Code Section 9200 If this document is executed outside of the State of California, The affidavit of verification is to be executed before a notary public or other officer authorized to administer oaths. My name is:______________________________________________ Address: _______________________________________________________ Phone number: _____________________________ I am informed that an adoption proceeding relating to (adoptee) Superior Court of California, County of San Mateo Juvenile Division 222 Paul Scannell Drive San Mateo, CA 94402 www.sanmateocourt.org Case # _________________________________________________ was completed in the County of San Mateo, (complete first and last name and date of birth) the adoption took place took place in the County of San Mateo on or about __________________________. The names of the adopting parents are ______________________________________________________. (complete first and last names) My relationship to the adoptee and adoptive parents is: _______________________________________ Please check the box or boxes that apply: Pursuant to Family Code §9200  I request permission to inspect the adoption records of the above referenced adoptee for the reasons set forth in the attached declaration. I understand that if my request is granted the name’s of my birth parents and any other information that might identify them shall be deleted from the documents or copies thereof.  I request copies of the adoption records of the above referenced adoptee for the reasons set forth in the attached declaration. I understand that if my request is granted the name’s of my birth parents and any other information that might identify them shall be deleted from the documents or copies thereof. You must attach a detailed declaration stating the reasons for your request. If you checked both boxes above you must provide a separate declaration for each request. AFFIDAVIT OF VERIFICATION I am the applicant in the foregoing matter. I have read the foregoing application and know the contents thereof. I certify or declare under penalty of perjury that the foregoing is true and correct. __________________________________________ Print Name _______________________________________ Signature Executed this ___________ day of ________________ 20____ at _______________________________ ADOPT-8 (updated 3-30-11) American LegalNet, Inc. www.FormsWorkFlow.com