Judicial Council of California Form ADOPT-210, Adoption Agreement Instructions
This form contains 65 fields organized into 25 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Additional Parents Indicator | ||
| Additional Parents Indicator | Checkbox |
Check this box if there are more adopting parents.
|
| Adopting Parent Information | ||
| Adopting Parent 1 Name | Text |
Enter the full name of the first adopting parent.
|
| Adopting Parent 2 Name | Text |
Enter the full name of the second adopting parent, if applicable.
|
| Adopting Parent Address | Text |
Provide the street address of the adopting parent(s).
|
| Adopting Parent City | Text |
Enter the city of residence for the adopting parent(s).
|
| Adopting Parent State | Text |
Enter the state of residence for the adopting parent(s).
|
| Adopting Parent Zip Code | Text |
Enter the five-digit zip code of residence for the adopting parent(s).
|
| Adopting Parent Telephone Number | Text |
Provide the telephone number of the adopting parent(s).
|
| Adopting Parent Lawyer Information Line 1 | Text |
Provide the first line of the lawyer's name, address, telephone number, e-mail address, and State Bar number, if applicable.
|
| Adopting Parent Lawyer Information Line 2 | Text |
Continue providing additional lawyer information such as address details, additional contact numbers, or State Bar number, if needed.
|
| More Adopting Parents | Checkbox |
Check this box if there are more adopting parents and you are providing their information on a separate piece of paper.
|
| Adopting Parent Or Parents | ||
| Adopting Parent Name(s) | Text |
Enter the full name of the adopting parent or parents.
|
| Adopting Parent's Signature | ||
| Adopting Parent's Signature Date | Date |
Enter the date the adopting parent signed this form.
|
| Adopting Parent's Signature Printed Name | Text |
Enter the adopting parent's printed full name.
|
| California Witness Type | ||
| Notary public (the notary acknowledgment is attached) | CheckBox | |
| Court clerk | CheckBox | |
| Probation officer | CheckBox | |
| Qualified court investigator | CheckBox | |
| Authorized representative of a licensed adoption agency | CheckBox | |
| County welfare department staff member | CheckBox | |
| Case Information | ||
| Adopting Parent or Parents | Text |
Enter the full name(s) of the adopting parent or parents.
|
| Case Number | Text |
Enter the official case number assigned to this filing.
|
| Case Number | ||
| Case Number | Text |
Provide the case number for this form.
|
| Child Information | ||
| Child's Name Before Adoption | Text |
Enter the child's full name as it was recorded before the adoption.
|
| Child's Name After Adoption | Text |
Enter the child's full name as it will be after the adoption.
|
| Child's Date of Birth | Date |
Provide the child's complete date of birth.
|
| Child's Age | Text |
Enter the child's current age in years.
|
| Child's Signature | ||
| Child's Signature Date | Date |
Enter the date the child signs the adoption agreement.
|
| Child's Printed Name | Text |
Enter the child's full name, to be printed for their signature.
|
| Court Filing Information | ||
| Court Name and Address | Text |
Provide the full name of the court and its street address.
|
| Case Number | Text |
Enter the official case number assigned by the court.
|
| Execution Method | ||
| Executed outside of hearing | Checkbox |
Check this box if the form was signed outside of a hearing, for a stepparent adoption to confirm parentage where a hearing was not ordered or appearance was waived.
|
| Executed at hearing | Checkbox |
Check this box if the form was signed at a hearing in front of a judicial officer.
|
| Executed by parent at remote hearing | Checkbox |
Check this box if the form was signed by the adopting parent or parents either before or during a remote hearing and was acknowledged by the judicial officer.
|
| First Adopting Parent Signature | ||
| First Adopting Parent Signature Date | Date |
Enter the date of the first adopting parent's signature.
|
| First Adopting Parent Signature Name | Text |
Enter the full name of the first adopting parent for their signature.
|
| First Adopting Parent Signature Details | ||
| First Parent Signature Date | Date |
Provide the date the first adopting parent signed.
|
| First Parent Printed Name | Text |
Provide the typed or printed name of the first adopting parent.
|
| General | ||
| Print this form | Button | |
| Save this form | Button | |
| Clear this form | Button | |
| Judge's Date | ||
| Judge's Date | Date |
Enter the date provided by the Judge or Judicial Officer.
|
| Legal Parent Signature | ||
| Legal Parent Signature Date | Date |
Enter the date the legal parent signed the document.
|
| Legal Parent Printed Name | Text |
Enter the legal parent's printed name.
|
| More Adopting Parents Indicator | ||
| More Adopting Parents | Checkbox |
Check this box if there are more adopting parents than space provided, and you will attach a separate piece of paper with the required information.
|
| Non-California Witness Type | ||
| Non-California Notary public | Checkbox |
Check this box if the form was signed outside of California in front of a notary public and the notary acknowledgment is attached.
|
| Non-California Other person authorized to perform notarial acts | Checkbox |
Check this box if the form was signed outside of California in front of another person authorized to perform notarial acts and proof of notarization is attached.
|
| Non-California Authorized representative of adoption agency | Checkbox |
Check this box if the form was signed outside of California in front of an authorized representative of an adoption agency that is licensed in the state or country where the form was signed.
|
| Second Adopting Parent Signature | ||
| Second Adopting Parent Signature Date | Date |
Enter the date the second adopting parent signed the form.
|
| Second Adopting Parent Printed Name | Text |
Enter the typed or printed name of the second adopting parent.
|
| Second Adopting Parent Signature Details | ||
| Second Adopting Parent Signature Date | Date |
Enter the date the second adopting parent signed the form.
|
| Second Adopting Parent Name | Text |
Enter the typed or printed name of the second adopting parent.
|
| Signature Jurisdiction | ||
| 1. Signed in California | Checkbox |
Check this box if the form was signed within California.
|
| 2. Signed outside of California | Checkbox |
Check this box if the form was signed outside of California.
|
| Spouse's Consent Signature | ||
| Spouse's Consent Date | Date |
Enter the date the spouse or registered domestic partner is signing the consent form.
|
| Spouse's Printed Name | Text |
Provide the printed name of the spouse or registered domestic partner.
|
| Third Adopting Parent Signature | ||
| Third Adopting Parent Signature Date | Date |
Provide the date when the third adopting parent signed the form.
|
| Third Adopting Parent Signature Name | Text |
Enter the full name of the third adopting parent who signed the form.
|
| Tribal Customary Adoption Order Date | ||
| Tribal Customary Adoption Order Date | Date |
Enter the date of the tribal customary adoption order.
|
| Witness Information | ||
| Witness County Signed | Text |
Enter the county where the form was signed by the witness.
|
| Witness State Signed | Text |
Enter the state where the form was signed by the witness.
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| Witness Country Signed | Text |
Enter the country where the form was signed by the witness.
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| Witness Name | Text |
Enter the full name of the witness.
|
| Witness Agency | Text |
Enter the name of the agency the witness works for, if applicable.
|
| Witness Date Signed | Date |
Enter the date the witness signed the form.
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