Form Ad 900a - Statement Of Understanding - Parent Who Did Not Give Physical Custody Of The Indian Child To The Petitioner(S) Page 5
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7STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
_____ 8. I understand I have the right to look for a lawyer to help me in the independent adoption process
and that the petitioner(s) may be required to pay the cost, up to $500 unless the petitioner(s) and I
agree to a higher amount, of such legal counsel.
_____ 9.
I understand if I am not sure I want my child adopted, there are other places the agency can refer
me to that could help me with family, health, money, and other problems.
_____ 10. I understand I may talk about my plan of adoption for my child with other professional people, my
family, and friends.
_____ 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If the adoption is withdrawn, dismissed or denied, the agency will notify me and request that I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).
However, my child may still be able to get benefits from his/her tribe or Bureau of Indian Affairs’
services if he/she is an Indian.
_____ 14. I understand the adoption agency may release identifying information from the adoption case
record only when:
_____ a. It has been requested by certain agencies as named in law because the information is
needed to help my child;
_____ b. My child, when he/she is an adult, and I have signed forms agreeing to the release of
identifying information so that contact can be arranged;
_____ c. My child has reached 21 years of age, asks for my identity and I have agreed in writing
to the release of my identity and most current address in the adoption agency’s records;
_____ d. My child has reached 21 years of age and has indicated in writing that I may have
his/her adopted name and most current address as indicated in the adoption agency’s
records, and I have asked for this information; or
_____ e. My child is under 21 years of age and the adoption agency has found that the release
of my identity and most current address as indicated in the agency’s records, is justified
according to law.
_____ 15. I understand I will be able, at any time, to add information about myself to the records of the
agency that investigates the independent adoption.
PAGE 5 OF 7
AD 900A (6/17) PARENT WHO DID NOT GIVE PHYSICAL CUSTODY (NON-CUSTODIAL) OF THE INDIAN CHILD TO THE PETITIONER(S)
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