ADOPT-331 Order for Appointment of Confidential Intermediary

ADOPT-331, Page 1 of 1
Judicial Council of California, www.courtinfo.ca.gov
New January 1, 2008, Mandatory Form
Family Code, § 9205(c)(g)(h)
Cal. Rules of Court, rule 5.410
Fill in court name and street address:
Superior Cour t of Ca l iforni a , County of
ADOPT-331
Order for Appointment of
Confiden tial Intermediary
Order for Appointment of
Confid ential Intermediary
Case Number:
Clerk fills in case number when form is filed.
COURT WILL FILL OUT SECTION BELOW
The judicial officer has read and reviewed the Request for Appointment of
Confidential Intermediary (ADOPT-330) filed by
(Name):
asking the court to appoint a confidential intermediary. The court orders as
follows:
5
The request for appointment of confidential intermediary is granted.
1
5
One or both siblings are adoptees. The following is hereby appointed
as the confidential intermediary:
2
California Department of Social Services
a.
A licensed adoption agency (name of agency):
b
.
5
3
5
The request is denied because the court finds t hat granting this request would be detrimental to the adopt ee or
the sibling with whom contact is sought.
4
The licensed adoption agency will not serve as a confidential intermediary because of economic hardship. The
following entity or pers on is appointed as the alternate confidentia l intermediary:
5
A copy of this order and the request (ADOPT-330) is to be forwarded to the person making this request.
5
5
A copy of this order and the request (ADOPT-330) is to be provided to the confidential intermediary named
above.
6
Address:
Name:
Phone number:
a.
b
.
c.
Judge (or Judicial Officer)
Date:
IMPORTANT: A confidential intermediary must not use any information found in the records of the adoptee or
sibling unless the use is authorized in the Family Code, section 9205(g) and rule 5.410 of the California Rules of
Court.
Clerk stamps date here when form is filed.
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