SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE HEMET 880 N. State St., Hemet, CA 92543 INDIO 46-200 Oasis St., Indio, CA 92201 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address): RIVERSIDE 4175 Main St., Riverside, CA 92501 RI-A809 FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): IN THE MATTER OF THE PETITION OF: CASE NUMBER: PETITION FOR FREEDOM FROM PARENTAL CUSTODY AND CONTROL Your petitioner respectfully represent(s) and allege(s): (PETITIONER'S NAME) that the following named (listed below) minor(s) is/are a person(s) under the age of eighteen and that said person(s) is/ are within the said County of Riverside: Name DOB City/State of Birth to mother, and That said child(ren) is/are person(s) defined in Family Code Section(s) Sections(s) as to father, of the Family Code, and acts amendatory thereto, and , his wife, that the said person(s) has/have been left in care of by his/her/their parents without any provision for support, and without communication from said parent(s), with the intent on the part of said parent(s) to abandon said person(s) continuously since to the time of filing this petition. That said person(s) is/are now in the custody and control of and and that an award of custody to the parent(s) would be detrimental to the child and an award of custody to a non-parent is required to serve the best interests of the child(ren). NOTE: Attach certified copy of minor(s) birth certificate(s) to original petition. Page 1 of 2 Adopted for Mandatory Use Riverside Superior Court RI-A809 [Rev. 6/2/11] PETITION ­ FREEDOM FROM PARENTAL CUSTODY AND CONTROL Family Code § 7800 riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER: RESPONDENT: CASE NUMBER That the names and addresses of the parents, guardian and relative are: Name FATHER MOTHER GUARDIAN RELATIVE (IF ADDRESS OF PARENTS IS UNKNOWN) Address (Give additional facts in detail) (If this petition is based on the provisions of Family Code 7823 through 7829, additional facts must be alleged. Addendum pages may be used for this purpose) WHEREFORE, your petitioner(s) pray(s) that this Court inquire into such matter, and that said person(s) be declared free from the custody and control of parent(s) as provided in 7800 et seq. of the Family Code hereinbefore mentioned, and for such other and further relief as the Court may deem proper. (DATE) (PETITIONER) (ATTORNEY FOR PETITIONER) (PETITIONER) VERIFICATION I am the petitioner(s) in the above entitled matter, I have read the foregoing petition and know the contents thereof and that the same is true of my own knowledge except as to those matters which are therein stated upon information and belief, and as to those matters that I believe it to be true. (SIGNATURE) (DATE) I certify (or declare) under penalty of perjury that the foregoing is true and correct. Page 2 of 2 Adopted for Mandatory Use Riverside Superior Court RI-A809 [Rev. 6/2/11] PETITION ­ FREEDOM FROM PARENTAL CUSTODY AND CONTROL Family Code 7800 riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com