en-USSUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELESen-USIn the matter of (Adoptee222s name):en-USCase Numberen-USAPPLICATION TO OBTAINen-USINFORMATION REGARDING AN ADOPTION en-USI am one of the following parties:en-US Adopteeen-US Adoptive Parenten-US Attorney for Adoptive Parenten-USI am seeking to obtain a copy of the following records for the reasons set forth below: en-USAdoption Order (ADOPT-215) en-USAdoption Request (ADOPT-200) en-USAdoption Agreement (ADOPT-210)en-USI am also seeking to obtain the following records: en-USOther Name of Adoptive Parent(s): þ Date of Adoption: þ Adoptee222s Birthdate: þ en-USReason for request: en-USen-USen-USen-USI am en-US(Provide identifying information of applicant and relationship to above parties)en-USAddress: en-USNO. STREET CITY STATE ZIPen-USPhone: en-USDate: Place: , Californiaen-USI certify and declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.en-USen-US(en-USSignature) en-US(FC 247 9200 prohibits release of any adoption informationen-US223except in exceptional circumstances and for good causeen-USapproaching the necessitous.224)en-USCK 057 (Rev. 08/18) For Mandatory Useen-USCode en-US247en-US FC9200en-USAPPLICATION TO OBTAIN INFORMATIONen-USREGARDING AN ADOPTION American LegalNet, Inc. www.FormsWorkFlow.com