(Court use only) Petition for Adoption of an Adult________________ 1. Your name(s) adopting parent(s): a. __________________________________________ b. __________________________________________ Your address (skip if you have an attorney) Street: _______________________________________ City: _______________________ State: ____ Zip: ___________ Phone number: ( ) __________________________ Your lawyer (if you have one): (Name, address, phone # and state bar#) Superior Court of California, County of San Mateo 222 Paul Scannell Drive San Mateo, CA 94402 650-312-5395 650-312-8881 (fax) www.sanmateocourt.org Case Number: ____________________________________________ ____________________________________________ ____________________________________________ 2. Person to be adopted (name): ____________________________________________ Date of Birth:__________________________  Male  Female Age:___________ Street: _______________________________________ City: _______________________ State: _______ Zip: ___________ 3. The adoptive parent(s) is/are older than the adult to be adopted.  Yes  No 4. The adoptive parent  is is not the spouse of the adult to be adopted. 5. The adoptive parent and adult to be adopted have: a.  Resided together as parent and child for (state number of years and/or months): b.  Are related as (describe family relationship , for example, aunt and nephew): c.  Are not related as family, but have established the following relationship (describe relationship and length): ADOPT-4 (updated 3-30-11) 1 American LegalNet, Inc. www.FormsWorkFlow.com 6. We are asking for the adoption because (state reasons, attach additional pages if necessary): 7. The adoption is in the best interest of the adult to be adopted, the adopting parent(s) and the public because (state reasons, attach additional pages if necessary): 8.  The mother of the adult to be adopted is still living. Her name and address if known are: Street: _______________________________________ City: _______________________ State: _______ Zip: ___________ 9.  The mother of the adult to be adopted is deceased. 10.  The father of the adult to be adopted is still living. His name and address if known are: Street: _______________________________________ City: _______________________ State: _______ Zip: ___________ 11.  The father of the adult to be adopted is deceased. 12. If the adopting parent(s) has/have adopted other adult(s) you must list name(s) and date(s) and place(s) of the adoption(s). (attach additional pages if necessary): 13.  The adult to be adopted is married and their spouse is in agreement with the adoption; their declaration in support of the adoption is attached. 14.  My spouse is not adopting the adult listed in section 2 but is in support of the adoption; their declaration in support of the adoption is attached. ADOPT-4 (updated 3-30-11) 2 American LegalNet, Inc. www.FormsWorkFlow.com 15. Petitioners request the court to grant the petition for adoption and to declare that each petitioning adoptive parent and the adult to be adopted shall sustain toward one another the legal relation of parent and child, with all the rights and duties of the relationship. 16. Petitioners request that the adopted adult’s name:  remain the same  be changed to: (state full adoptive name): ______________________________________________________ (Type or Print Name) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ___________________________________ (Type or Print Name) ________________________________________ (Signature of Adopting Parent) Date: ___________________________________ (Type or Print Name) _________________________________________ (Signature of Adopting Parent) Date: ___________________________________ (Type or Print Name) _________________________________________ (Signature of Adult to be Adopted) ADOPT-4 (updated 3-30-11) 3 American LegalNet, Inc. www.FormsWorkFlow.com