NAME, ADDRESS AND TEL. OF ATTORNEY OR PARTY WITHOUT ATTORNEY ATTORNEY FOR FOR COURT USE ONLY ATTORNEY BAR # SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE 341 THE CITY DRIVE P.O. BOX 14171 ORANGE, CA 92863-1571 IN THE MATTER OF THE ADOPTION PETITION OF: ________________________________________________ ________________________________________________ Adopting Parent(s) Petition to Determine Parental Rights of Alleged Natural Father and to Determine Necessity of Consent (Family Code Section 7662) CASE NUMBER: The petitioner(s) _________________________________________________________________respectfully represent(s) and allege(s): 1. That the minor child involved in these proceedings is ______________________________________ , born on ________________________ . Said minor is presently within the County of Orange, State of California, in the custody of ____________________________________ , for the purpose of adoption. 2. That petitioner is a person or representative of an agency described in § 7662 of the Family Code as a party authorized to file this petition, to wit: _______________________________________________ . 3. That _______________________________________________________ is the mother of said minor. 4. a. G That the minor’s mother was married at the time said minor was born. b. G That minor’s mother was not married at the time minor was born, nor for 300 days proceeding such birth. 5. That the natural father of said minor is _________________________________________________________ , who resides at __________________________________________________________________________________ . 6. a. G That the minor’s mother and said father did not cohabit. b. G That the minor’s mother and said father cohabited for the period from ________________________ to ___________________________ . 7. That the minor’s mother and said father did not attempt to marry each other before or after the birth of said child. 8. That the father did not openly hold out the child as his natural child and receive it as such into his home. 9. That no child support payments, other than in token amounts, have been made by said father, voluntarily, or pursuant to court order, to petitioner or any other person for the support of said minor, and he has failed to communicate with said minor. 10. That no action has been brought, nor is any action pending for the purpose of having declared the existence or nonexistence between the parties of the relation of parent and child. 11. (If father is unknown): That the facts concerning the conception are_____________________________________ __________________________________________________________________________________________ . 12. That the father does / does not know about my pregnancy. 13. The father, to my knowledge, is / is not presently in the Armed Services. 14. (Any further relevant facts): (over) 479 (1/99) Petition to Determine Parental Rights of Alleged Natural Father and to Determine Necessity of Consent (Family Code Section 7662) American LegalNet, Inc. www.FormsWorkflow.com WHEREFORE, the petitioner prays that the Court find and declare that __________________________________________ is the natural mother of said child; that __________________________________________________ is the natural father of said child; and that the consent of said father is not necessary for the adoption of said child. _____________________________________________ ______________________________________________ ATTORNEY FOR PETITIONER SIGNATURE OF PETITIONER ______________________________________________ SIGNATURE OF PETITIONER VERIFICATION I have read the foregoing Petition to Determine Parental Rights of Alleged Natural Father and to Determine Necessity of Consent and know the contents thereof; and that the same is true of my own knowledge, except as to the matters which are therein stated upon my information or belief, and as to those matters that I believe them to be true. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on __________________________ at __________________________________________________ , California. (DATE) (PLACE) _____________________________________________________________ (SIGNATURE OF PETITIONER) _____________________________________________________________ (SIGNATURE OF PETITIONER) 479 (1/99) Petition to Determine Parental Rights of Alleged Natural Father and to Determine Necessity of Consent (Family Code Section 7662) American LegalNet, Inc. www.FormsWorkflow.com