Judicial Council of California, www.courts.ca.gov

fe28bdd5ad6df07dcac1926bf92f2f4a128dba82

California Superior Local Rules

If your sibling is currently a dependent of the court, you must follow the procedure in Welfare and Institutions Code

section 388(

b) instead of using this form. Before completing this form, you must ask for contact with your sibling from the department or licensed adoption agency that joined in your adoption or your sibling's adoption. If you do not know the name of the department or agency, ask the California Department of Social Services, Adoption Services Branch, 916-651-8089. After filling out this form, bring it and a blank copy of the proposed Order (ADOPT-331) to the clerk of the court where the adoption was finalized.

After the court signs the order, a copy of this Request and the Order will be forwarded to the California Department of Social Services or the adoption agency, as designated by the court, and copies will be given to you. 1 I am asking the court to appoint a confidential intermediary to help me get contact information for my sibling. a. My name: b. My address: c. My phone number: 2 a. The person helping me complete this request for the appointment of a confidential intermediary is:

(1) Name: My attorney (State Bar No. ) My guardian ad litem

(2) Address:

(3) Phone number: b. I do not have an attorney or guardian ad litem who is helping me complete this request for the appointment of a confidential intermediary. 3 An attorney used to represent me. a. Name of former attorney: b. Address of attorney: c. Phone number of attorney: d. This attorney used to represent me because: 4 The department or the licensed adoption agency that joined in the adoption petition for: me my sibling a. Name of agency: b. Address: c. Phone number: ADOPT-330, Rev.

January 1, 2024 Request for Appointment of Confidential Intermediary Your name: Case Number: 5 The sibling whom I would like to contact is: a. My sibling’s name: b. My sibling’s current address (if known): c. My sibling is under the age of 18 years.

(2) My sibling used to live with (name and relationship to my sibling, if known):

(1) My sibling currently lives with (name and relationship to my sibling, if known): 6 My sibling was adopted in this county: Yes No Unknown My sibling was previously a dependent of the court in this county: Yes No Unknown The following are true (check all that apply): a. I submitted a written California Department of Social Services waiver form AD 904A or AD 904B to the agency listed in before I completed this form.4 b. The agency in sent a letter to me stating that no waiver for my sibling is in its file. A copy of the letter from the agency is attached to this request. 4 c.

I am asking the court to appoint a confidential intermediary to help me get contact information for my sibling. d. I am under the age of 18 years.

(1) My parent/guardian signed a consent giving me permission to contact my sibling: Yes No

(2) The court signed a consent giving me permission to contact my sibling: Yes No e. My sibling is under the age of 18 years. f. To the best of my knowledge, there is not now, and never has been, an order stating that I cannot have contact with the sibling named in .5 Any other information that would be helpful to the court: I declare under penalty of perjury under the laws of the State of California that the information in items through 9, and in all attachments, is true and correct, which means that if I lie on this form, I am committing a crime.

Date: Type or print your name Sign your name Date: Type or print your name Signature Attorney Guardian ad litem ADOPT-330, Person who helped the applicant complete the form:

Document details

Collection	California Superior Local Rules
Citation	fe28bdd5ad6df07dcac1926bf92f2f4a128dba82
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	fe28bdd5ad6df07dcac1926bf92f2f4a128dba82

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