ADOPT-210 1 Adoption Agreement Clerk stamps date here when form is filed. Your name(s) (adopting parent(s)): a. b. Relationship to child: Address (skip this if you have a lawyer): City: Zip: State: Telephone number: Lawyer (if any): (Name, address, telephone numbers, e-mail address, and State Bar number): Fill in court name and street address: Superior Court of California, County of 2 Child's name before adoption: Child's name after adoption: Date of birth: Court fills in case number when form is filed. Case Number: Age: Signing this forms: � Adoptions usually require a hearing where most signatures on this form must be completed in front of a judge. � Item 4(b) may be signed before the hearing. � If this is a stepparent adoption to confirm parentage involving a spouse or registered domestic partner who gave birth to the child during the union, usually no hearing is required and you may sign this form in front of a proper witness. See paragraph 8(a) for instructions on having your signature properly witnessed. If the court orders a hearing in this case, you must sign this form at the hearing in front of the judge. � All other signatures must be signed at a hearing, in front of a judge, unless waived by the judge for good cause. 3 I am the child listed in 2 and I agree to the adoption. (Not required in the case of a tribal customary adoption under Welf. & Inst. Code, � 366.24.) Date: Type or print your name Signature of child (child must sign if 12 or older; optional if child is under 12) 4 If there is only one adopting parent, read and sign below. a. I am the adopting parent listed in 1 , and I agree that the child will: (1) Be adopted and treated as my legal child (Fam. Code, � 8612(b)) and (2) Have the same rights as a natural child born to me, including the right to inherit my estate. Date: Type or print your name Judicial Council of California, www.courts.ca.gov Revised January 1, 2016, Mandatory Form Family Code, �� 8602�8606, 8612, 9000.5, 9003; Welfare and Institutions Code, � 366.24; Cal. Rules of Court, rule 5.730 Signature of adopting parent ADOPT-210, Page 1 of 3 Adoption Agreement American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Your name: b. I am married to, or the registered domestic partner of, the adopting parent listed in 1 , and I am not a party to this adoption. I agree to his or her adoption of the child. Date: Type or print your name Signature of spouse or registered domestic partner (may be signed before hearing) 5 If there are two adopting parents, read and sign below. We are the adopting parents listed in 1 , and we agree that the child will: a. Be adopted and treated as our legal child (Fam. Code, � 8612(b)) and b. Have the same rights as a natural child born to us, including the right to inherit our estate. I agree to the other parent's adoption of the child. Date: Type or print your name Signature of adopting parent I agree to the other parent's adoption of the child. Date: Type or print your name Signature of adopting parent 6 If this is a tribal customary adoption, read and sign below. I/we are the adopting parents listed in 1 , and I/we agree that the child will: a. Be adopted and treated as my/our legal child (Fam. Code, � 8612(b)) and b. Have the same rights and duties stated in the tribal customary adoption order dated attached). If two adopting parents, we agree to the other parent's adoption of the child. Date: Type or print your name (copy Signature of adopting parent Date: Type or print your name Signature of adopting parent 7 For stepparent 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 am the spouse or 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 Revised January 1, 2016 Adoption Agreement ADOPT-210, Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Your name: 8 Executed (check one): a. This form was signed outside of a hearing. (Select this option only for a stepparent adoption involving a spouse or partner who gave birth to the child during the union, where the court did not order a hearing for good cause.) (1) This form was signed in California This form was signed in front of the following type of witness (check one): notary public (the notary acknowledgment is attached) court clerk probation officer qualified court investigator authorized representative of a licensed adoption agency county welfare department staff member (2) This form was signed outside of California This form was signed in front of the following type of witness (check one): notary public (the notary acknowledgment is attached) other person authorized to perform notarial acts (proof of notarization is attached) authorized representative of an adoption agency that is licensed in the state or country where this form was signed (3) Witness information This form was signed in: (county) Name of witness: Agency witness works for (if applicable): Date: Witness signature: b. This form was signed at a hearing in front of a judicial officer. (The judge will date and sign the form below.) (state) (country) Date: Judge (or Judicial Officer) Revised January 1, 2016 Adoption Agreement ADOPT-210, Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com