Fillable Form 13 19673 360 (Superior Court of California)

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Form 13 19673 360 (Superior Court of California)

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13-19673-360 rev. 03/28/18 PETITION FOR ADOPTION OF ADULT OR MARRIED MINOR Fam C. §9300
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
EMAIL ADDRESS:
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
IN THE MATTER OF:
__________________________________________________, Adopting Person
PETITION FOR ADOPTION OF ADULT OR MARRIED MINOR
CASE NUMBER:
Petitioner(s) (name) ____________________________________________________________ respectfully represent(s) and
allege(s):
☐Petitioner (Adopting Person) is an adult who is older than the proposed Adoptee.
Petitioner (Adopting Person) seeks to adopt:
Proposed Adoptee (name): ____________________________________
Date of Birth: _________ Age: __________ Place of Birth: ____________________________________
☐Person with developmental disabilities ☐Married Minor, date of marriage: ________________________
Proposed Adoptee resides: ________________________________________________________________________
Full names of spouse(s) (if applicable)
Petitioner (Adopting Person): ______________________________________________________________________
Proposed Adoptee: _______________________________________________________________________________
☐Spouse(s) consent(s) has been filed concurrently with this petition.
Full names and place of residence of any living parents and/or adult children of Proposed Adoptee: ___________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
13-19673-360 rev. 03/28/18 PETITION FOR ADOPTION OF ADULT OR MARRIED MINOR Fam C. §9300
In the Matter of
Case No.
Petitioner (Adopting Person) or Petitioner’s Spouse:
☐Has previously adopted an adult. Date and place of adoption: ___________________________________
☐Has NOT previously adopted an adult
☐Is a provider or employee of a provider of board and care, treatment, rehabilitation, or other services to persons with
developmental disabilities
☐Is NOT a provider or employee of a provider of board and care, treatment, rehabilitation, or other services to persons with
developmental disabilities
Petitioner (Adopting Person) and Proposed Adoptee request the adoption for the following reason: ____________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
The Adopting Person and Proposed Adoptee entered into an agreement in writing in which Adopting Person agrees to
adopt Proposed Adoptee and parties agree to assume towards each other the legal relation of parent and child and to have
all the rights and be subject to all the duties and responsibilities of that relationship. ☐The Adoption Agreement is filed
concurrently with this petition.
The Petitioner (Adopting Person) desire to adopt Proposed Adoptee and give him or her name of
__________________________________________________ and Proposed Adoptee desire to be so adopted and be
given such name.
Wherefore, parties pray the court to approve the agreement of adoption, and make a decree that Proposed Adoptee
_____________________________________ has been duly and legally adopted by Petitioner (Adopting Person)
_____________________________________ and shall be known as ______________________________________
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 Petitioner (Adopting Person)
Date:
__________________________________ __________________________________________
Type or Print Name Signature of Adoptee
Date:
___________________________________ ___________________________________________
Type or Print Name Signature of Attorney for Petitioner
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Form 13 19673 360 (Superior Court of California)

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Completed 20 July 2020

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