ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FAX NO.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF IN THE MATTER OF: ORDER ON PETITION FOR BIRTH RECORD INFORMATION CASE NUMBER: After reviewing the verified petition and the records provided by California Department of Social Services, the court finds good and compelling cause is shown to grant the following orders: The clerk is ordered to furnish Petitioner with a copy of the following documents, upon payment of any fees required by law: __________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ The clerk is ordered to permit Petitioner to examine the following records: _________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Date: ___________________________ ____________________________________________________ Judicial Officer of the Superior Court Health & Saf. Code §102705 Family Code §8619, 9200 American LegalNet, Inc. www.FormsWorkFlow.com Form 13-21910-360 Rev 08/10/16 ORDER ON PETITION FOR BIRTH RECORD INFORMATION