Madera — Petition to Declare Minor Free from Parental Custody and Control (MAD-JUV-021)

Source: https://www.madera.courts.ca.gov/system/files/forms-and-filings/mad-juv-021-petition-declare-minor-free-parental-custody-and-control-new-11-01-2023_0.pdf

MAD-JUV-021 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA STREET ADDRESS: 200 South G Street MAILING ADDRESS: 200 South G Street CITY AND ZIP CODE: Madera, CA 93637 BRANCH NAME: Juvenile Division IN RE: PETITION TO DECLARE MINOR FREE FROM PARENTAL CUSTODY AND CASE NUMBER: CONTROL

1. The petitioner(s) ___________________________________________ respectfully represent(s) and allege(s) that the child(ren) listed below is/are a person(s) under the age of 18 and that said person(s) is/are within the County of Madera: Name Date of Birth City/State of Birth

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2. Petitioner(s)etitioner(s) request(s) an order and judgment declaring the child(ren) free from the custody and control of:

Name Relationship to Child(ren)

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Pursuant to the following statues: Family Code section 7822

The child(ren) has/have been left without provision for the child’s identification by the child(ren)’s parent(s).

The child(ren) has/have been left by the parent(s) named above in the care and custody of another person for a period of six months without any provision for the child(ren)’s support, or without communication from the parent(s), with the intent on the part of the parent(s) to abandon the child(ren).

The parent(s) named above has/have left the child(ren) in the care and custody of the other parent for a period of one year without any provision for the child(ren)’s support, or without communication from the parent(s), with the intent on the parent(s) to abandon the child(ren). -and-

Abandonment commenced (date): ______________ and continued through (date): ________________

Form Adopted for Optional Use PETITION TO DECLARE MINOR FREE FROM PARENTAL CUSTODY Page 1 of 3 Madera Superior Court Local Form AND CONTROL MAD-JUV-021 [New 11/01/2023]

MAD-JUV-021 CASE NUMBER: IN RE:

Family Code section 7823 – The child(ren) has/have been neglected or cruelly treated by the parent(s) named above, the child(ren) has/have been a dependent of the juvenile court, and the parent(s) have been deprived of the child(ren)’s custody for one year before the filing of this petition.

Family Code section 7824 – The parent(s) named above suffer(s) a disability because of the habitual use of alcohol or drugs, the child(ren) has/have been a dependent of the juvenile court, and the parent(s) has/have been deprived of the child(ren)’s custody for one year before filing this petition.

Family Code section 7825 – The parent(s) named above has/have been convicted of a felony, the facts of which are of such nature so as to prove the unfitness of the parent(s) to have future custody and control of the child(ren).

Family Code section 7826 – The parent(s) named above has/have been declared by a court of competent jurisdiction, wherever situated, to be developmentally disabled or mentally ill.

Family Code section 7827 – The parent(s) named above is/are mentally disabled and is/are likely to remain so un the foreseeable future.

Probate Code section 1516.5 – A guardian has been appointed for the child(ren), and one or both parents do not have legal custody of the child(ren); the child(ren) has/have been in the physical custody of the guardian for a period of not less than two years; and the child(ren) would benefit from being adopted by their guardian.

Additional facts in support of allegations (give additional facts in detail, added pages may be used for this purpose):

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3. The names and addresses of parent(s) and guardian(s) are:

Name(s) Address(es)

Father: _______________________________________ _____________________________________________

Mother: _______________________________________ _____________________________________________

Guardian(s): ___________________________________ _____________________________________________

It is in the best interest of the child(ren) to be declared free from the custody and control of the parent(s) named in section 2 above.

Form Adopted for Optional Use PETITION TO DECLARE MINOR FREE FROM PARENTAL CUSTODY Page 2 of 3 Madera Superior Court Local Form AND CONTROL MAD-JUV-021 [New 11/01/2023]

MAD-JUV-021 CASE NUMBER: IN RE:

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 parent(s) named in section 2 above as provided in Family Code section 7800 et. Seq, and for such other and further relief as the court may deem proper.

VERIFICATION

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date: SIGN

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(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)

Date: SIGN

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(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)

Date: SIGN

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(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR PETITIONER)

Form Adopted for Optional Use PETITION TO DECLARE MINOR FREE FROM PARENTAL CUSTODY Page 3 of 3 Madera Superior Court Local Form AND CONTROL MAD-JUV-021 [New 11/01/2023]