Fillable Form 13 21910 360 (Superior Court of California)

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Form 13 21910 360 (Superior Court of California)

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Form 13-21910-360 ORDER ON PETITION FOR BIRTH RECORD INFORMATION Health & Saf. Code §102705
Rev 08/10/16 Family Code §8619, 9200
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
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
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
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Form 13 21910 360 (Superior Court of California)

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Completed 18 July 2020

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