ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
EMAIL ADDRESS:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
APPLICATION TO OBTAIN FINAL ADOPTION ORDER AND ORDER
If you do not know the case number, enclose a $15.00 research fee plus a self-addressed stamped envelope for the
return of the documents. If you are the original petitioner of the adoption, enclose a copy of your driver license.
I, _____________________________________________, do hereby request the court for permission to obtain a copy or
certified copy of the final adoption order as requested below:
1. Child’s name: __________________________________________ Child’s date of birth _____________________
2. City and State where the adoption took place:______________________________________________________
3. Date or approximate date of adoption: ___________________________ Type of adoption: _________________
4. Adopting parent’s name: _______________________________________________________________________
5. Reason for the request: (may attach additional pages)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
6. Relationship to adopted individual: _______________________________________________________________
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
Date: ____________________________ Signature: ___________________________________________
ORDER
□ Denied □ Set for Hearing: ______________________________________________________________
□ Good cause appearing therefore, permission is hereby granted the above named applicant to obtain a copy and/or
certified copy of the final adoption order.
Dated: __________________ Judge of the Superior Court __________________________________________
Form 13-21911-360 APPLICATION TO OBTAIN FINAL ADOPTION ORDER AND ORDER Family Code §9200
Rev 08/11/2016
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