For Court Use Only SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR THE COUNTY OF KINGS In the Matter of the Petition of Case Number___________________ STEPPARENT ADOPTION } Consent to Adoption by Parent In California Giving Custody to Husband or Wife of Other Parent _______________________________ Petitioner I, ______________________________, being the natural father/mother of (Name of parent) , (Name of Minor) do hereby give my full and free consent to the adoption of said child by , the (Name of Petitioner-Stepparent) the petitioner herein, it being fully understood by me that with the signing of this document, my consent may not be withdrawn except with Court approval, and with the signing of the order of adoption by the Court, I shall give up all my rights of custody, services, and earnings of said child, and said child cannot be reclaimed by me. Said child was born on in (Date) and is the child of , (City and State) and (Name of Natural Father) Date 20 . (Name of Natural Mother) . X (PRINT NAME) ____________ _______ (SIGNATURE OF PARENT) Signed in the presence of *Title *The Clerk of the Superior Court, the Probation Officer, or, where stepparent investigations are delegated to County Welfare Departments, a County Welfare Department Staff member may witness. NOTICE TO THE BIRTH PARENT WHO CONSENTS TO THE CHILD’S ADOPTION: If you or your child lived together at any time as parent and child, the adoption of your child by a stepparent does not affect the child’s right to inherit your property or the property of other blood relatives. For further information regarding this right of inheritance, you should consult an attorney at your own expense. This form is to be used only when parent is giving custody of the child to the husband or wife of other parent. AD 2A (7/89) Consent Stepparent inside CA / last revised on 12-19-05 American LegalNet, Inc. www.FormsWorkflow.com