Santa Barbara — SC-4033*

Source: https://www.santabarbara.courts.ca.gov/system/files/sc4033.pdf

Print Form Clear Form

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

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

PETITIONER ADOPTING PARENT:

PETITIONER ADOPTING PARENT:

PETITIONER ADOPTEE:

CASE NUMBER:

PETITION FOR APPROVAL OF ADOPTION AGREEMENT (ADULT) (Family Code Sections §9300 et seq.)

Petitioners are the proposed adopting parent(s) and the proposed adoptee. They jointly submit this petition.

1. The adopting parent’s name is: _________________________________________________

Date of birth: __________________ Place of birth: _________________

Current age: __________________

Current County/State/Country of Residence: ______________________________________

Spouse’s Name (If the adopting parent has no spouse, indicate “none.”):

---

Date of marriage: ______________

Consent of spouse is filed with this petition. (Consent is not necessary if the spouse is also a petitioner.)

Proposed adopting spouse is lawfully separated from his or her spouse, therefore consent is not necessary.

The adopting parent’s name is: _______________________________________________

Date of birth: __________________ Place of birth: _________________

Current age: __________________

Current County/State/Country of Residence: _______________________________________

Spouse’s Name: ____________________________________________

Date of marriage: ______________

2. The proposed adoptee’s name is: ________________________________________________

Date of birth: __________________ Place of birth: _________________

Current age: __________________

Current County/State/Country of Residence: _______________________________________

Does the proposed adoptee have a spouse? Yes No

(If yes) Spouse’s Name ________________________________________________________

(Check one) Consent of spouse is filed with this petition.

Proposed adoptee is lawfully separated from his or her spouse, therefore consent is not

necessary.

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 1 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019] Print Form Clear Form

Print Form Clear Form

Insert Case Name: CASE NUMBER:

3. The names and addresses of any living birth parents or adult children of the proposed adoptee are as follows (Attach additional pages as Attachment 3, if necessary):

(Name of Birth Mother) (Address of Birth Mother)

(Name of Birth Father) (Address of Birth Father)

(Name of Adult Child of Proposed Adoptee) (Address of Adult Child)

(Name of Adult Child of Proposed Adoptee) (Address of Adult Child)

4. The following describes the length and nature of the adopting parent's and the adoptee's relationship including the degree of kinship, if any (attach additional pages as Attachment 4):

   The adopting parent(s) and adoptee are not related.

5. The prospective adoptive parent(s) is/are a provider of board and care, treatment, habilitation, or other

services to persons with developmental disabilities or is a spouse or employee of a provider. The proposed adoptee is an adult with developmental disabilities.

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 2 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019] Print Form Clear Form

Print Form Clear Form

(Continued)

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 3 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019]

Print Form Clear Form

Print Form Clear Form

Insert Case Name: CASE NUMBER:

6. (Check all that apply) The adopting parent or his/her spouse adopted another unrelated adult more than one year preceding the filing of this petition. The circumstances of the adoption are detailed in Attachment 6. Neither the adopting parent nor her/his spouse has adopted another unrelated adult within one year of filing this petition. The adopting parent or his/her spouse has adopted another unrelated adult within one year of filing this petition (check one): The adopting parent and/or the adopting parent's spouse have/has adopted another adult whose name is __________________________________________ within one year of the filing of this petition, but the current proposed adoptee is: the biological sibling of the previously adopted adult, and/or disabled or physically handicapped. The Order for the prior adoption is attached as Attachment 6. The adopting parent and/or the adopting parent's spouse have/has adopted another adult whose name is __________________________________________ within one year of the filing of this petition and the circumstance of the adoption are detailed in Attachment 6. The Order for the prior adoption is attached as Attachment 6.

7. We have agreed and have filed with this petition a signed agreement to assume toward each other the legal relation of parent(s) and child and to have all of the rights and be subject to all of the duties and responsibilities of that relationship.

8. The following explains why the adoption is sought and why we believe this adoption is in the best interest of the adopting parent(s), the adoptee and the public (attach additional pages as Attachment 8, if needed):

Because this adoption will establish legally a relationship that has existed in fact, and because it is in the best interest of the parties to have the legal rights and obligations of parent and child, including rights relating to inheritance and duties of support. This adoption is in the public's interest for the same reasons and particularly because it will

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 4 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019] Print Form Clear Form

Print Form Clear Form

create legal duties of support between the adopting parent(s) and adoptee and thereby reduce the likelihood of the parties becoming a public charge in the future.

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 5 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019] Print Form Clear Form

Print Form Clear Form

Insert Case Name: CASE NUMBER:

9. The proposed adoptee wishes to take the family name of the adopting parent(s) and requests the court order

the adoptee's new name to be: _______________________________________________________________.

Date: Signature of Attorney for Adopting Parents (if any)

VERIFICATION

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

(Date and Place) (Print name of adopting parent) (Signature of adopting parent)

(Date and Place) (Print name of adopting parent) (Signature of adopting parent)

(Date and Place) (Print name of adoptee) (Signature of adoptee)

Form Adopted for Mandatory Use PETITION FOR APPROVAL OF ADOPTION AGREEMENT Page 6 of 6 Santa Barbara Superior Court (ADULT) SC-4033 [New January 2019] Print Form Clear Form