Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 12 (Rev. 3/1 9 /19) PETITION FOR APPROVAL OF ADULT ADOPTION AGREEMENT Page 1 of 3 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) : NAME OF ADOPTING PARENT STREET ADDRESS CITY, STATE, ZIP NAME OF ADULT BEING ADOPTED STREET ADDRESS CITY, STATE, ZIP TELEPHONE NO: FAX NO. (Optional): E - MAIL ADDRESS (Optional) : ATTORNEY FOR (Name) : FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 200 South G Street 200 South G Street Madera, CA 93637 Juvenile Division IN THE MATTER OF THE ADOPTION PETITION OF: NAME OF ADULT BEING ADOPTED PETITION FOR APPROVAL OF ADULT ADOPTION AGREEMENT CASE NUMBER: Petitioners allege: 1. Petitioner NAME OF ADULT BEING ADOPTED is an adult person, who is INSERT AGE years of age, born on MONTH,DATE AND YEAR OF BIRTH, in CITY, STATE, and now residing at STREET ADDRESS, CITY, STATE & ZIP. Petitioner NAME OF ADULT BEING ADOPTED DESCRIBE MARITAL STATUS IF MARRIED, INCLUDING SPOUSES NAME AND DATE/PLACE OF MARRIAGE OR IS NOT MARRIED 2. Petitioner NAME OF ADOPTING PARENT is an adult person who is INSERT AGE years of age, born on MONTH, DATE AND YEAR OF BIRTH, in CITY, STATE, and now residing at STREET ADDRESS, CITY, STATE & ZIP. Petitioner NAME OF ADOPTING PARENT DESCRIBE MARITAL STATUS IF MARRIED, INCLUDING SPOUSES NAME AND DATE/PLACE OF MARRIAGE OR IS NOT MARRIED. 3. On or about DATE ADOPTION AGREEMENT WAS SIGNED, petitioners entered into and executed a written adoption agreement in which petitioner NAME OF ADOPTING PARENT agreed to adopt petitioner NAME OF ADULT BEING ADOPTED, petitioner NAME OF ADULT BEING ADOPTED agreed to be adopted by petitioner NAME OF ADOPTING PARENT, and both petitioners agreed to assume towards each other the legal relation of parent and child and to have all the rights and be subject to all the duties and responsibilities of that relation. A copy of the Adoption Agreement is attached hereto as Exhibit A and made a part hereof. 4. The spouse of NAME OF ADULT BEING ADOPTED, NAME OF SPOUSE OF ADOPTED PERSON, has duly consented in writing to the adoption sought herein. A copy of his/her consent is attached hereto as Exhibit B and made a part hereof. Not married 5. The spouse of NAME OF ADOPTIONG PARENT,NAME OF SPOUSE OF ADOPTING PARENT, has duly consented in writing to the adoption sought herein. A copy of his/her consent is attached hereto as Exhibit B and made a part hereof. Not married American LegalNet, Inc. www.FormsWorkFlow.com Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 12 (Rev. 3/1 9 /19) PETITION FOR APPROVAL OF ADULT ADOPTION AGREEMENT Page 2 of 3 6. Petitioner NAME OF ADOPTING PARENT desires to adopt petitioner NAME OF ADULT BEING ADOPTED, and petitioner NAME OF ADULT BEING ADOPTED desires to be so adopted. 7. INDICATE THE FAMILY RELATIONSHIP BETWEEN THE PARTIES, SUCH AS STEPCHILD, OR NEPHEW. 8. DESCRIBE THE LENGTH AND NATURE OF THE RELATIONSHIP BETWEEN THE PARTIES. 9. STATE REASONS WHY THIS ADOPTION IS SOUGHT AND IS IN THE BEST INTEREST OF THE PARTIES AND THE PUBLIC. 10. The names and addresses of the living parents and adult children of adult being adopted are as follows: FATHER'S NAME AND ADDRESS, MOTHER'S NAME AND ADDRESS, ADULT CHILDREN NAME AND ADDRESS. 11. IF THE ADOPTING PARENT, OR THE ADOPTING PARENTS SPOUSE HAS PREVIOUSLY ADOPTED AN ADULT, ENTER THE NAME AND DATE OF THAT ADOPTION. IF NOT, REMOVE THIS PARAGRAPH. I have not previously adopted. 12. Petitioner NAME OF ADULT BEING ADOPTED wishes to be known by INSERT CURRENT NAME or NEW NAME. WHEREFORE, petitioners pray that the court permit all persons concerned in this matter to attend and be heard, and that the court examine all persons appearing before it as required by law, and if satisfied that the best interests of the parties and the public interest will be promoted by the proposed adoption, grant the petition, approve the agreement of adoption, and make a decree that NAME OF ADULT BEING ADOPTED has been duly and legally adopted by petitioner NAME OF ADOPTING PARENT. Dated: DATE SIGNED NAME OF ADOPTING PARENT Dated: DATE SIGNED NAME OF ADULT BEING ADOPTED VERIFICATION I, NAME OF ADOPTING PARENT, am one of the petitioners in the above-entitled proceeding. I have read the foregoing petition and know the contents thereof. The same is true of my own knowledge, except as to those matters which are therein alleged on information and belief, and, as to those matters, I believe it to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: DATE SIGNED American LegalNet, Inc. www.FormsWorkFlow.com Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 12 (Rev. 3/1 9 /19) PETITION FOR APPROVAL OF ADULT ADOPTION AGREEMENT Page 3 of 3 NAME OF ADOPTING PARENT American LegalNet, Inc. www.FormsWorkFlow.com