FOR COURT USE ONLY ATTORNEY OR PARTY WITHOUT ATTORNEY (N ame, State Bar Number and Address) TELEPHONE NO.: FAX NO: (Optional) ATTORNEY FOR (NAME): PETITIONER: ORDER ON THE PETITION TO DECLARE MINOR/S FREE FROM PARENTAL CUSTODY AND CONTROL AND TERMINATE PARENTAL RIGHTS CASE NUMBER: AMADOR COUNTY SUPERIOR COURT 500 ARGONAUT LANE JACKSON, CA 95642 (209) 257 - 2600 A petition to terminate the parental rights of , who is the Presumed father Mother of the child, who is the subject of this adoption, having come on regularly for hearing, and a notice of hearing having been given as required by law, and the Court being advised of the circumstances, the Court finds as follows: is the natural mother of the subject minor whose date of birth is , and who is now in the custody of the above-named adopting parent. The presumed father of such child has been served notice of this action. It is therefore the ORDER OF THIS COURT that the parental rights of the presumed father/mother be terminated. Dated Judge of the Superior Court ORDER ON PETITION TO DECLARE MINOR FREE FROM PARENTAL CUSTODY AND CONTROL OF PARENT FOR STEPPARENT ADOPTION www.amadorcourt.org FC-201 Approved for Optional Use American LegalNet, Inc. www.FormsWorkFlow.com