Santa Barbara — SC-4041

Source: https://www.santabarbara.courts.ca.gov/system/files/sc-4041.pdf

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ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.: FOR COURT USE ONLY

EMAIL ADDRESS (Optional) ATTORNEY FOR (NAME):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA

Santa Barbara–Anacapa Santa Maria-Cook Lompoc Division
1100 Anacapa Street 312-C East Cook Street 115 Civic Center Plaza

Santa Barbara, CA 93101 Santa Maria, CA 93454 Lompoc, CA 93436

MATTER OF:

CASE NUMBER:

ORDER GRANTING PETITION FOR FREEDOM FROM PARENTAL CUSTODY AND CONTROL

This Court heard the petition of (your name(s)) ____________________________________ for an order declaring

(child’s name) _________________________________ (“the minor”) free from the parental custody and control of

(name of parent(s) whose rights are being terminated) _____________________________________________ on

______________ (date).

This Court has examined petitioner(s), the minor child and other witnesses as necessary, and has considered
the verified petition and other evidence, if offered, and finds:

1. Service of the citation was accomplished as prescribed by law or by this court.

2. The court investigator has filed a report as required by Fam. C. § 7851 and recommends that the minor
be freed from the custody and control of the parent(s).

3. (Name of parent retaining custody) ________________________________ has executed a consent to
the request to free the child from the custody and control of the parent.

4. The Indian child inquiry was made, is sufficient, and the court finds that the Indian Child Welfare Act
does not apply.

The child is an Indian child and the court finds:
a. by clear and convincing evidence that active efforts were made to provide remedial services
and rehabilitative programs designed to prevent the breakup of the Indian family and that these
efforts have proved unsuccessful; and
b. beyond a reasonable doubt that the continued custody of the child by the parent is likely to
result in serious emotional or physical damage to the child.

Optional Form ORDER GRANTING PETITION FOR FREEDOM FROM PARENTAL Fam. Code §7800 et seq. SC-4041 [New July 1, 2020] CUSTODY AND CONTROL Page 1 of 2

Matter of: Case Number:

5. There is clear and convincing evidence that the parent:
a. abandoned the minor within the meaning of Family Code section 7822;
b. neglected or cruelly treated the child(ren) within the meaning of Family Code section 7823;
c. suffers from a disability due to alcohol, controlled substances, or depravity within the
meaning of Family Code section 7824;
d. has been convicted of a felony, the facts of which are of such a nature so as to prove
unfitness of the parent to have the future custody and control of the child within the meaning of
Family Code section 7825;
e. was declared developmentally disabled or mentally ill within the meaning of Family Code
section 7826;
f. is mentally disabled within the meaning of Family Code section 7827.

6. It is in the best interests of the minor to be declared freed from the custody and control of the parent
and there is no less detrimental alternative to provide for the child’s best interests.

IT IS HEREBY ORDERED that ________________________________ (name of child) is freed from the custody

and control of _____________________________________ (name of parent(s) whose rights are being terminated).

SIGN

Dated: Judge of the Superior Court

Optional Form ORDER GRANTING PETITION FOR FREEDOM FROM PARENTAL Fam. Code §7800 et seq. SC-4041 [New July 1, 2020] CUSTODY AND CONTROL Page 2 of 2 Print Form Clear Form