Form Ad 926 - Statement Of Understanding - Parent Who Places The Child With The Prospective Adoptive Parent(S) Page 3
Download a blank fillable Form Ad 926 - Statement Of Understanding - Parent Who Places The Child With The Prospective Adoptive Parent(S) in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Ad 926 - Statement Of Understanding - Parent Who Places The Child With The Prospective Adoptive Parent(S) with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
Any removals of children from care due to child abuse or neglect:
___________________________________________________________________________________
__________________________________________________________________________________
Family:
Length of current marriage/relationship: ___________________________________________________
General residence location or, if requested, specific address:
___________________________________________________________________________________
___________________________________________________________________________________
Other children and adults residing in the home of the prospective adoptive parent(s):
___________________________________________________________________________________
___________________________________________________________________________________
RIGHTS OF BIRTH PARENT
___ 3. I understand if I do not wish to place my child for adoption with the prospective adoptive parent(s), I should
not sign this form and the adoption placement agreement.
___ 4. I understand I have the right to look for a lawyer to help me in the Independent Adoption process and
that the prospective adoptive parent(s) may be required to pay the cost, up to $500 unless the
prospective adoptive parent(s) and I agree to a higher amount, of such legal counsel.
___ 5. I understand I may talk about my plan to place my child for adoption with other professional people, my
family and friends.
___ 6. I understand if I am not sure I want to place my child for adoption, there are other places the agency can
refer me to that could help me with family, health, money, and other problems.
___ 7. I understand I have a right to a minimum of three separate counseling sessions with an Adoption
Service Provider or a licensed psychotherapist of my choice which, at my request, will be paid for by the
prospective adoptive parent(s).
___ 8. I understand the adoption placement agreement will automatically become an irrevocable consent to
adoption either when the 30-day period has ended or when I sign a Waiver of the Right to Revoke
Consent (AD 929), whichever occurs first. The first day of the 30-day period is the day the adoption
placement agreement is signed.
___ 9. If I change my mind after I sign the adoption placement agreement I must sign and deliver to the California
Department of Social Services or to the delegated county adoption agency, whichever is investigating the
proposed adoption, a written statement revoking the adoption placement agreement and requesting that
the child be returned to me. I may not revoke the adoption placement agreement after the 30-day period
has ended or after I signed a Waiver of the Right to Revoke Consent (AD 929), whichever occurs first. The
first day of the 30-day period is the day the adoption placement agreement is signed.
___10. After the adoption placement agreement becomes irrevocable, I may regain custody of the child only if the
prospective adoptive parent(s) agree(s) to withdraw his/her/their petition for adoption or if the court denies
the adoption petition.
___11. I understand I will remain legally responsible for my child until the adoption is granted by the court. If the
adoption is withdrawn, dismissed or denied, the agency will notify me and request that I make other
plans for the child. I understand I must keep the agency informed of my current address.
___12. I understand if I ask the agency which investigates the proposed adoption for information at any future
time, the agency must give me all known information about the status of my child’s adoption including
the approximate date the adoption was completed and if the adoption was not completed or was
vacated, for any reason, whether adoptive placement of my child is again being considered.
___13. I understand after my child’s adoption has been granted in court, all inheritance rights from any blood
relatives will end unless they have made arrangements in their will or in a trust which specifically
includes my child. My child will legally inherit from his/her adoptive parent(s).
AD 926 (7/17) PARENT WHO PLACES THE CHILD WITH THE PROSPECTIVE ADOPTIVE PARENT(S)
PAGE 3 OF 5
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Ad 927 - Statement Of Understanding - Parent Who Places The Indian Child With The Prospective Adoptive Parent(s)
Legal
Form Ad 900a - Statement Of Understanding - Parent Who Did Not Give Physical Custody Of The Indian Child To The Petitioner(s)
Legal
Form Ad 900 - Statement Of Understanding - Parent Who Gave Physical Custody Of The Indian Child To The Petitioner(s)
Legal
Form Ad 887a - Statement Of Understanding - Parent Who Did Not Give Physical Custody Of The Child To The Petitioner(s)
Legal
Related Categories
Parent category: Legal