Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 03 (Rev. 3/1 9 /19 ) PETITION TO INSPECT AND OR OBTAIN COPIES OF BIRTH RECORD Page 1 of 3 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) (Telephone Number) ATTORNEY FOR (NAME): COURT USE ONLY SUPERIOR COURT OF CALIFORNIA 225 COUNTY OF MADERA Juvenile Division 200 South G Street Madera, CA 93637 In the Matter of the Petition of Adoption of: PETITION TO INSPECT AND OR OBTAIN COPIES OF ADOPTION RECORD [FAMILY CODE 9200] CASE NUMBER: THIS FORM IS TO BE USED TO PETITION THE COURT TO INSPECT OR COPY ADOPTION RECORDS OF THE MADERA COUNTY SUPERIOR COURT. PURSUANT TO FAMILY CODE SECTION 9200, THE COURT IS REQUIRED TO DELETE THE NAME OF THE CHILD222S BIRTH PARENTS OR ANY INFORMATION TENDING TO IDENTIFY THE CHILD222S BIRTH PARENTS FROM THE DOCUMENT OR COPIES PRIOR TO RELEASE. I am the Petitioner and submit the following: 1. My name is: 2. My mailing address is: 3. My residence address is: County of: 4. My telephone number is: 5. My birth date is: 6. I am now years old. 7. I am informed that an adoption proceeding related to (adoptee) was completed in the County of Madera, on or about by (adopting parents). 8. (Family Code 9200) I request permission to inspect the records and or obtain copies of the records contained in the court file relating to the adoptee , for the following reasons: (Family Code 9200 requires a showing of exceptional circumstances and good cause approaching the necessitous.) (Attach additional pages if needed) American LegalNet, Inc. www.FormsWorkFlow.com Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 03 (Rev. 3/1 9 /19 ) PETITION TO INSPECT AND OR OBTAIN COPIES OF BIRTH RECORD Page 2 of 3 9. For the reason stated, I request permission to obtain to inspect all of the following document(s): Adoption Petition Relinquishment/Consent Adoption Agreement Adoption Order Report to the court from any investigating agency Other: 10. Attached is a copy of a government issued current photographic identification card of the petitioner. I request an order of the Superior Court as required by Family Code section 9200 with respect to the records relating to the above proceeding. Date: ( Signature of Petitioner ) VERIFICATION I am the petitioner in the above matter. I have read this petition and I know and understand what it states. I declare that the petition is true based upon my own personal knowledge, except as to those matters where it is stated to be based upon my information and belief, and as to those matters, I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the above is true and correct. Date: ( Signature of Petitioner ) American LegalNet, Inc. www.FormsWorkFlow.com Madera Superior Court Form Adopted for Optional Use MAD - JUV - 00 03 (Rev. 3/1 9 /19 ) PETITION TO INSPECT AND OR OBTAIN COPIES OF BIRTH RECORD Page 3 of 3 CALIFORNIA FAMILY CODE 9200 Confidentiality of records; Certificate of adoption (a) The petition, relinquishment or consent, agreement, order, report to the court from any investigating agency, and any power of attorney and deposition filed in the office of the clerk of the court pursuant to this part is not open to inspection by any person other than the parties to the proceeding and their attorneys and the department, except upon the written authority of the judge of the superior court. A judge of the superior court may not authorize anyone to inspect the petition, relinquishment or consent, agreement, order, report to the court from any investigating agency, or power of attorney or deposition or any portion of any of these documents, except in exceptional circumstances and for good cause approaching the necessitous. The petitioner may be required to pay the expenses for preparing the copies of the documents to be inspected. (b) Upon written request of any party to the proceeding and upon the order of any judge of the superior court, the clerk of the court shall not provide any documents referred to in this section for inspection or copying to any other person, unless the name of the child222s birth parents or any information tending to identify the child222s birth parents is deleted from the documents or copies thereof. (c) Upon the request of the adoptive parents or the child, a clerk of the court may issue a certificate of adoption that states the date and place of adoption, the child222s birth date, the names of the adoptive parents, and the name the child has taken. Unless the child has been adopted by a stepparent, the certificate shall not state the name of the child222s birth parents. (Amended by Stats. 2002, Ch. 784, Sec. 114. Effective January 1, 2003.) American LegalNet, Inc. www.FormsWorkFlow.com