Amador — AD-2

Source: https://amador.courts.ca.gov/system/files/forms-and-filings/ad2.pdf

STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

Original for Court Record Certified Copy for State Department of Social Services

IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR THE COUNTY OF

In the Matter of the Petition of STEPPARENT ADOPTION

Consent to Adoption by Parent
Petitioner Retaining Custody }

I, the undersigned, being the parent of give my full and
Name of Minor

free consent to the adoption of said child by , who is Name of Petitioner (Stepparent)

my husband/wife/domestic partner without relinquishing any of my rights, duties, obligations as his/her parent, and I respectfully ask that the petition be granted.

Said child was born on in and is the child
Date City and State

of and Name of Legal Parent Name of Legal Parent SIGN

Date 20 Signature of Parent

Signed in the presence of

*Title

• The Clerk of the Superior Court, the Probation Officer, or, where stepparent investigations are delegated to County Welfare Departments, a County Welfare Department Staff member may witness.

This form for use only when person giving consent is husband or wife of petitioner or domestic partner, as defined in Family Code Section 297, of petitioner.

Original for court record, certified copy to be sent immediately to California Department of Social Services, Sacramento.

AD 2 (6/02)