Cal. Code Regs. Tit. 22, § 35145 - Identifying Information on the Relinquishment Document
(a) The relinquishment document shall provide
for identification of:
(1) The child's:
(A) Name as identified on the birth
certificate.
1. Any discrepancy between the
name of the child on the relinquishment form and on the birth certificate shall
be clarified by an affidavit, signed by the authorized representative of the
agency who accepted the relinquishment of the child.
(i) The affidavit shall be filed with the
court when the court report and relinquishment form are filed.
(ii) A copy of the affidavit shall be sent to
the department when the certified copy of the relinquishment form is
filed.
(B)
Sex.
(C) Birthdate.
(D) Place of birth.
(2) The name of the relinquishing
parent.
(3) The agency's name,
address, and telephone number.
(4)
The name or names of the person or persons with whom the relinquishing parent
intends that placement of the child for adoption be made by the agency, if the
relinquishing parent chooses to name such person or persons.
(A) If the relinquishing document does not
provide for identification of the person or persons, the name or names shall be
stated on the AD 922 signed by the relinquishing parent and attached to the
relinquishment document, in which case neither page alone shall constitute a
valid relinquishment.
1. A relinquishment
document to which the AD 922 is attached shall include substantially the
following statement: "This relinquishment document includes a second page that
names the person or persons with whom I/we intend that the child be placed for
adoption."
(b) When the relinquishing parent does not
name the person or persons with whom he or she intends that placement of the
child for adoption be made by the agency and the child is not subject to the
Indian Child Welfare Act, the following relinquishment document shall be used
for taking the relinquishment of:
(1) A
Mother or Presumed Father not Denying Paternity:
(A) In California and signing relinquishment
in presence of agency accepting relinquishment: AD 501.
(B) In California and signing relinquishment
in presence of an agency different from the one accepting the relinquishment:
AD 503.
(C) Not in California and
not signing before military officer: AD 501A.
(D) Not in California and signing before
military officer: AD 504.
(2) A Presumed Father Denying Paternity:
(A) In California and signing relinquishment
in presence of agency accepting relinquishment: AD 585.
(B) In California and signing relinquishment
in presence of an agency different from the one accepting the relinquishment:
AD 583.
(C) Not in California: AD
584.
(3) An Alleged
Father not Denying Paternity:
(A) In
California: AD 586.
(B) Not in
California and not signing before military officer: AD 591.
(C) Not in California and signing before
military officer: AD 593.
(4) An Alleged Father Denying Paternity: AD
588.
(5) An Alleged Father Waiving
Right to Further Notice: AD 590.
(c) When the relinquishing parent does not
name the person or persons with whom he or she intends that placement of the
child for adoption be made by the agency and the child is subject to the Indian
Child Welfare Act, the following relinquishment document shall be used for
taking the relinquishment of:
(1) A Mother or
Presumed Father not Denying Paternity:
(A) In
California and signing relinquishment in presence of agency accepting
relinquishment: AB 864.
(B) In
California and signing relinquishment in presence of an agency different from
the one accepting the relinquishment: AD 865.
(C) Not in California: AD
863.
(2) A Presumed
Father Denying Paternity:
(A) In California
and signing relinquishment in presence of agency accepting relinquishment: AD
866.
(B) In California and signing
relinquishment in presence of an agency different from the one accepting the
relinquishment: AD 873.
(C) Not in
California: AD 867.
(3)
An Alleged Father not Denying Paternity:
(A)
In California: AD 868.
(B) Not in
California: AD 862.
(d) When the relinquishing parent names the
person or persons with whom he or she intends that placement of the child for
adoption be made by the agency the following relinquishment document shall be
used for taking the relinquishment of:
(1) A
Mother or Presumed Father not Denying Paternity and not Subject to Indian Child
Welfare Act:
(A) In California and signing
relinquishment in presence of agency accepting relinquishment: AD
921.
(2) An Alleged
Father not Denying Paternity and not Subject to Indian Child Welfare Act:
(A) In California: AD
920.
(3) An individual in
all other relinquishment circumstances: The relinquishment document listed in
Sections 35145(b) or (c)
which is appropriate to the relinquishment parent's status and the AD
922.
Notes
2. Change without regulatory effect amending NOTE filed 8-2-91 pursuant to section 100, title 1, California Code of Regulations (Register 91, No. 52).
3. Repealer of subsection (b) and new subsections (a)(4)-(d)(3) filed 9-8-93; operative 10-7-93 (Register 93, No. 37).
4. Change without regulatory effect amending section and NOTE filed 3-27-95 pursuant to section 100, title 1, California Code of Regulations (Register 95, No. 13).
Note: Authority cited: Sections 10553 and 10554, Welfare and Institutions Code; and Section 8621, Family Code. Reference: Section 8700, Family Code.
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