Sonoma — Petición de información sobre registros de nacimiento FL-095

Source: https://sonoma.courts.ca.gov/system/files/fl-095.pdf

Name, Address of Petitioner or Attorney Telephone No.

PETITIONER

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA 3055 CLEVELAND AVENUE SANTA ROSA, CA 95403

In the Matter of the Petition of:

PETITION FOR BIRTH RECORD INFORMATION CASE NUMBER:
(California Family Code Section 9200)

THIS FORM TO BE USED TO PETITION THE COURT TO INSPECT OR COPY ADOPTION RECORDS OF THE SONOMA COUNTY SUPERIOR COURT. PURSUANT TO FAMILY CODE SECTION 9200, THE COURT IS REQUIRED TO DELETE THE NAME OF THE CHILD’S BIRTH PARENTS OR ANY INFORMATION TENDING TO IDENTIFY THE CHILD’S BIRTH PARENTS FROM THE DOCUMENT OR COPIES PRIOR TO RELEASE My Name: _____________________________________________________________________________ My Permanent Residence Address is: _________________________________________________________ in the County of _____________________, State of ___________________________. I was born on _________________________ and am now __________ years of age. I am informed and believe that I was adopted by __________________________________________________ and _______________________________________________on or about ___________________________, in the County of Sonoma, State of California. OR I am informed that an adoption proceeding relating to _______________________________ was completed in Sonoma County, State of California on or about __________________________, by _________________________________ and __________________________________ adoptive petitioners. My relation to said persons is as follows: (Please state relation to adoptee and adoptive petitioners): ____________________________________________________________________________.

Form Number: FL-095 PETITION FOR BIRTH RECORD INFORMATION Page 1 of 2 Effective Date: 6/25/13

I request permission to inspect the records and/or obtain copies of records relating to the birth of the named person. The facts that make such an order necessary are:

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___________________________________________________________________________________________. I specifically request to be allowed to inspect the following adoption records:

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Pursuant to Family Code section 9200, I request the release of records relating to the above proceedings. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct to the best of my knowledge and belief.

DATED: _______________________ _______________________________________ Petitioner’s Signature

Form Number: FL-095 PETITION FOR BIRTH RECORD INFORMATION Page 2 of 2 Effective Date: 6/25/13