3. The names and addresses of parent(s), guardian and relative are:
Father: ____________________________________________________________________________________________
Mother: ___________________________________________________________________________________________
Guardian:__________________________________________________________________________________________
Relative(s):_________________________________________________________________________________________
Additional facts in support of allegations: (Give additional facts in detail, added pages may be used for this purpose)
□It is in the best interest of the child(ren) to be declared free from the custody and control of the above-named
parent(s).
Wherefore, petitioner(s) request(s) that this court inquire into such matter, and that said child(ren) be declared free
from the custody and control of the above-named parent(s) are provided in Family Code § 7800 et seq, and for such
other and further relief as the court may deem proper.
Date: ________________________ Print Name: __________________________________________
Signature: ___________________________________________
Date: ________________________ Print Name: __________________________________________
Signature: ___________________________________________
VERIFICATION
I am the petitioner(s) in the above-entitled matter; I have read the foregoing petition and know the contents thereof
and that the same is true of my own knowledge except as to those matters which are therein stated upon information
and belief, and as to those matters that I believe to be true.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on ________________________ at ____________________________________________________, California
_______________________________________ _______________________________________
Signature of Petitioner Signature of Petitioner
_______________________________________
Signature of Attorney for Petitioner
SB-9006 Family Code §7800
Revised 6/24/2016 Page 2 of 2
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