Fill and Sign the Prospective Adoptive Parent Form

JV-322 Confidential Informatio n — Clerk stamps da t e here when for m is filed Prospective Adoptive Parent This information must be k e pt unde r seal in the cour t file . The court, the child’ s attorney, the c hild’ s CASA voluntee r i f any, and the ag e nc y may look at this information. 1 Caregive r (name each): ––––– ––––– Care gi ver’s p h o n e n u mber: ––––– Fill in court na m e and street address: Caregiver’s address : ––––– S u p e ri o r C o urt of Ca l i f or n i a , Co u nt y of ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– Fill in child's name and date of bir t h: 2 Name of child : ––––– Child’s Name: ––––– C h il d’ s ph o n e n um b er : ––––– Date of Bi r t h: ––––– Child’s address: ––––– Cle r k fills in case n u mbe r w h en fo r m is filed. Ca s e Numb e r: ––––– ––––– ––––– ––––– ––––– ––––– 3 Name of child’s Indian custodian , if an y (na m e): ––––– Phone number of child’s Indian custodi a n: ––––– Address o f child’s Indi a n cu s t odian: ––––– ––––– ––––– ––––– ––––– ––––– Confidential Information— Prospective Adoptive Parent JV-32 2, Page 1 of 1e le c tr on ic fo rm ã 20 0 6- 7 WWW.LawCA.co m L a w P u b l i s h e r sJudicial Council of California, Revised January 1, 2007, Mandatory Form Welfare and Institutions Code, §§ 308, 366.26(n) Cal. Rules of Court, rules 5.726, 5.727, 5.728