ADOPT-225 Parent of Indian Child Agrees to End Parental Rights

I want my child to be adopted by (name(s)):
b.
Their rela tionship to Indi an child:
(Check all that apply)
Related to child (specify):
Members of child’s tribe Indian parents
None of the above
The parent(s) in
do not meet the placement
meet
preference requirements of the Indian Child Welfare Act.
Indian child
(name):
Date of birth: Age:
Child’s tribe(s):
Enrollment #:
Check here if you do not know the enrollment #.
Your name:
Father
(Check only one. Each parent fills out a separate form.)Mother
Your address (skip this if you have a lawyer):
Zip:
State:
City:
Enrollment #:Your tribe(s):
Phone #:
Check here if you do not know the enrollment #.
Your lawyer (if you have one): (Name, address, phone #, and State Bar #):
and I understand and say:I am the parent in
a. I agree to give up my parental rights.
I agree to the adoption of my child by the parent(s) listed in
c. I understand what will happen when I sign this form.
d. No one has threatened me or made promises to me to get me to sign this form.
e. I understand that until the judge signs an Adoptio n Order (ADOPT-215) or an order to end my parental
rights, I can change my mind and my child will be returned to me.
f.
g. I do not give up any of my rights under the Indian Child Welfare Act by signing this form.
Parent of Indian Child Agrees
ADOPT-225, Page 1 of 2
Judicial Council of California, www.courtinfo.ca.gov
Rev. January 1, 2005, Mandatory Form
to End Parental Rights
25 U.S.C. § 1913
5
4
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h. My child was at least 10 days old when I signed this form.
I want the court to let me know if the adoption is canceled so I can ask the court to give custody of my child
back to me. The court will give the custody of my child back to me if the judge decides it is in my child’s best
interest.
.
a.
1
b
.
i. I understand that notice of the adoption request will be sent to any Indian tribe of which my child may be a
member or eligible for membership.
ADOPT-225
Parent of Indian Child Agrees
to End Parental Rights
Clerk stamps below when form is filed.
Court name and street address:
Superior Court of California, County of
Case Number:
1
2
3
4
5
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1
1
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ADOPT-225 Parent of Indian Child Agrees to End Parental Rights PDF

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