Judicial Council of California, courts.ca.gov

9e39f6eba989b2c20c769ee1455a49fa54235437

California Superior Local Rules

Relationship to child: Address (skip this if you have a lawyer): Street: City: State: Zip: Telephone number: Federal law says the state courts must send a copy of all adoption orders for an Indian child to the Secretary of the Interior within 30 days. The state court must also send the following information. Please complete the rest of the form. 2 Indian child’s name: Date of birth: Age: 3 Indian child’s tribe (or tribe child is eligible for): Enrollment #: Check here if you do not know.

Check here if tribe does not have an enrollment number. 4 Indian child’s biological mother (name): Street address: City: State: Zip: Check here if you do not know. The biological mother attaches her request that her identity remain confidential. 5 Indian child’s biological father (name): Street address: City: State: Zip: Check here if you do not know. The biological father attaches his request that his identity remain confidential. ADOPT-220, For your protection and privacy, please press the Clear button after you have printed the form. Rev.

July 1, 2026 Adoption of Indian Child Your name: Case Number: 6 Indian child’s biological Indian grandmothers (names; include maiden names if you know them): Check here if you do not know. 7 Indian child’s biological Indian grandfathers (names): Check here if you do not know. 8 Name of any agency with information about this adoption: 9 Other people with information about the Indian child’s ancestry: Name Relationship to Child a. b. c. 10 Parental rights (check all that apply): a. A court ended parental rights on (date): b. Parental rights were modified under a tribal customary adoption order on (date): c.

Parents voluntarily agreed in writing to end their parental rights.

(1) Form ADOPT-225 (Parent of Indian Child Agrees to End Parental Rights) will be recorded in front of a judge and filed with the court before the adoption hearing on (date):

(2) Form ADOPT-225 was recorded in front of a judge and is attached to form ADOPT-200 (Adoption Request).

(3) Form ADOPT-225 was signed at least 10 days after the birth date of the Indian child. d. A judge has certified that he or she fully explained the terms and consequences of the parents’ agreement to end parental rights and that the parents understood.

(1) This certificate was filed with the court on (date): ; OR

(2) This certificate is attached to form ADOPT-200 or will be filed before the adoption hearing. 11 Note: The court will notify the American Indian tribe of the child’s adoption. ADOPT-220,

Document details

Collection	California Superior Local Rules
Citation	9e39f6eba989b2c20c769ee1455a49fa54235437
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	9e39f6eba989b2c20c769ee1455a49fa54235437

Source file is stored in the law ingest library (pdf).