SDSC JUV-195 (Rev. 8/22) ADOPTION AGREEMENT ADOPTION OF ADULT OR MARRIED MINOR (PROSPECTIVE ADOPTIVE PARENT AND PROPOSED ADOPTEE) ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, JUVENILE COURT MEADOW LARK DR., SAN DIEGO, CA NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA IN THE MATTER OF BIRTH NAME: ADOPTION AGREEMENT ADOPTION OF ADULT MARRIED MINOR (PROSPECTIVE ADOPTIVE PARENT AND PROPOSED ADOPTEE ) ADOPTION CASE NO.: 1. I/We, the undersigned prospective adoptive parent(s), having petitioned the above-entitled court for approval of the adoption of the proposed adoptee, agree to sustain toward the proposed adoptee the legal relation of parent and child subject to all the rights and duties of that relationship, including all legal rights and duties of custody, support, and inheritance.

Date: Type or print name Signature of Prospective Adoptive Parent Date: Type or print name Signature of Prospective Adoptive Parent 2. I, the undersigned proposed adoptee, having petitioned the above- entitled court for approval of the adoption by the prospective adoptive parent(s), do hereby agree to assume toward the prospective adoptive parent(

s) the legal relation of parent and child subject to all the rights and duties of that relationship, including all legal rights and dut ies of custody, support, and inheritance. 3. I do/ do not want the parental duties and responsibilities terminated for Name of Birth Parent. 4. I do/ do not want the parental duties and responsibilities terminated for Name of Birth Parent. Date: Type or print name Signature of Proposed Adoptee