ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
EMAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
IN THE MATTER OF THE PETITION OF:
ORDER ON PETITION TO TERMINATE PARENTAL RIGHTS OF ALLEGED
FATHER
The proceeding was heard on (date): _________________ at (time): _______________ in Dept.: ___________________
By Judge (name): ___________________________________________
□ Temporary Judge
On the verified petition filed (date): _____________________ by (name): ______________________________________
and notice of hearing having been given as required by law or notice to him having been dispensed with by order of the
court and the Court being advised in the premises, the Court finds:
That __________________________________________ is the natural mother of ________________________________
born on _____________________________ who is now within the County of San Bernardino in the custody of the
adopting parent(s) for the purpose of adoption; and that the alleged natural father of child is/is not the presumed father
of said child under Family Code 7611.
That no action has been brought nor is any action pending for the purpose of having declared the existence or
nonexistence of the relationship of parents and child with respect to said child.
It is therefore the order of this Court that the consent of said alleged natural father ______________________________
is not necessary for this adoption and his rights with reference to said child is hereby terminated.
Date ____________________ ____________________________________
Judge/Commissioner of the Superior Court
13-21904-360 ORDER ON PETITION TO TERMINATE PARENTAL RIGHTS Family Code §7660
Revised 8/10/2016 OF ALLEGED FATHER Page 1 of 1
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