ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name, State Bar number, and address): TELEPHONE NO: FAX NO. (Optional) EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ 1 Second Street, Room 300 Watsonville, CA 95076 Watsonville Branch IN THE MATTER OF THE PETITION OF : PETITION FOR AUTHORIZATION TO INSPECT ADOPTION AND BIRTH RECORD INFORMATION AND TO OBTAIN COPIES (TRANSMITTAL FAMILY CODE 247 9200 AND HEALTH AND SAFETY CODE 247 10275) CASE NUMBER: Form Adopted for MAN DATORY USE Superior Court of Santa Cruz County SUPCV 1092 10 / 15 /2018 PETITION FOR AUTHORIZATION TO INSPECT ADOPTION AND BIRTH RECORDS INFORMATION AND TO OBTAIN COPIES (FAMILY LAW) Page 1 of 4 SUP CV 1092 I am the Petitioner and submit the following: 1. Mailing address: 2. Residence address: , County of 3. Telephone numb er: Birth date://,and my current age 4. I am informed ( check one) : a. and believe that I was ad opted by (adopting parent(s)) on or about ( date ) , in the County of Santa Cruz. b. that an adoption proceeding related to (adoptee) was completed in the County of , on or about by (adopting parents). 5. (Family Code 2479200) 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 2479200 requires a showing of exceptional circumstances and good cause approaching the necessitous.) 6. (Health and Safety Code 247102705) I request permission to inspect and/or copy the original birth record conta ined in the State Department of Social Services files for the following reasons: (Health and Safety Code247102705 requires a showing of necessity of the order and good and compelling cause. The name and address of the natural parents shall be given to the petitioner only if he or she can demonstrate that the name and address, or either o f them, are necessary to assist him or her in establishing a legal right .) American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF THE PETITION OF: CASE NUMBER: Form Adopted for MAN DATORY USE Superior Court of Santa Cruz County SUPCV 1092 10 / 15 /2018 PETITION FOR AUTHORIZATION TO INSPECT ADOPTION AND BIRTH RECORDS INFORMATION AND TO OBTAIN COPIES (FAMILY LAW) Page 2 of 4 7. I request that the court confirm the dates that I was a Dependent in the Santa Cruz Superior Court system for the following reasons: 8. For the reasons stated, I request permission to obtain to inspect a copy of the following document(s) 9. Attached is a copy of a government issued current photographic identification card of the Petitioner. I request an order of the Superior Co urt as required by Family Code 2479200 and/or Health and Safety Code 247102705 with respect to the records relating to the above proceeding. Date: Print Name 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 matte rs where it is stated to be based upon my information and belief, and as to those matters, I believe them to be true. Date: Print Name Signature of Peti tioner California Family Code Section 9200 (a) The petition, relinquishment or consent, agreement, order, report to the court from any investigating agency, and any power o f attorney and disposition 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 j udge of the superior court may not authorize any on e 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 ca use a pproaching 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 child nts 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 t he date and place of hild has taken. Unless the child has been adopted by a California Health and Safety Code Section 102705 All records and information specified in this article, other than th e newly issued birth certificate, shall be available only upon the order of the superior court of the county of residence of the adopted child or the superior court of the county granting the order of adoption. No such order shall be granted by the superior court unless a verified petition setting forth facts showing the necessity of the order has been presented to the court and good and compelling cause is shown for the granting of the or der. The clerk of the superior court shall send a copy of the petition to the State Department of Social Services and the department shall send a copy of all records and information it has concerning the adopted person with the name and address of the nat ural parents removed to the court. The court must review these records before making an order and the order should so state. If the petition is by or on behalf of an adopted child who has attained majority, these facts shall be given great we ight, but th e granting of any petition is solely within the sound discretion of the court. The name and address of the natural parents shall be given to the petitioner only if he or she can demonstrate that the name and address, or either of them, are necessary to ass ist him or her in establishing a legal right. American LegalNet, Inc. www.FormsWorkFlow.com TRANSMITTAL TO BE COMPLETED AND SENT BY THE CLERK OF THE COURT TO SACRAMENTO ONLY IF PARAGRAPH SIX (6) OF THE PETITION HAS BEEN MARKED (Health and Safety Code 247 102705) Form Adopted for MAN DATORY USE Superior Court of Santa Cruz County SUPCV 1092 10 / 15 /2018 PETITION FOR AUTHORIZATION TO INSPECT ADOPTION AND BIRTH RECORDS INFORMATION AND TO OBTAIN COPIES (FAMILY LAW) Page 3 of 4 State Department of Social Services Adoptions Branch 744 P Street, M/S 19 - 31 Sacramento, CA 95814 To California State D.S.S.: The Original Petition seeking original birth records pursuant to Health and Safety Code 247 102705 was filed in the Santa Cruz County Superior Court on in Case Number . Please comply with Health and Safety Code section 102705 by sending a copy of all records and information it has co ncerning the adopted person with the name and address of the natural parents removed, to: Santa Cruz County Superior Court, Attention: Adoptions Clerk 1 Second Street Room 300 Watsonville , California 95076 Executive Officer/Clerk of the Superior Court of Santa Cruz County Date: Deputy Clerk (A copy of this request was sent by the Clerk of the Court to the Dep artment of Social Services on ) American LegalNet, Inc. www.FormsWorkFlow.com To be completed by Court Staff: Form Adopted for MAN DATORY USE Superior Court of Santa Cruz County SUPCV 1092 10 / 15 /2018 PETITION FOR AUTHORIZATION TO INSPECT ADOPTION AND BIRTH RECORDS INFORMATION AND TO OBTAIN COPIES (FAMILY LAW) Page 4 of 4 To Judge of the Superior Court: Attached are the records letter received by the Clerk of the Court from the State Department of Social Services after transmission of a copy of the attached verified petition to said department. Executive Officer/Clerk of the Superior Court of Santa Cruz County Date: Deputy Clerk FOR COURT USE ONLY COURT ORDER CASE NUMBER: The Court, having reviewed all of the attached records received from the State Department of Social Services and the foregoing verified petition and finding that good and compelling cause existed to review said records, now makes the following ORDER: ORDERED that the Petition i