Form Ad 887b - Statement Of Understanding - Alleged Natural Father
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4STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
STATEMENT OF UNDERSTANDING
INDEPENDENT ADOPTIONS PROGRAM
You will be consenting to the adoption of this child by signing the consent to adoption form.
Consenting means you agree to the permanent placement of this child with the petitioner(s) to raise
as his/her/their own. When the adoption petition is granted, you will no longer have any rights as a
parent to this child.
Before you sign this form and the consent to adoption form, read each of the attached statements in
consultation with the agency or California Department of Social Services’ representative.
Be sure to ask questions about any statement you do not understand. Consenting to the adoption of
this child is an extremely important decision. You should know all the facts and consequences
before making your decision.
Instructions On How To Complete This Statement Of Understanding:
BEFORE YOU SIGN THIS STATEMENT OF UNDERSTANDING AND THE CONSENT TO ADOPTION
FORM, READ BOTH VERY CAREFULLY WITH THE AGENCY REPRESENTATIVE. BE SURE TO ASK
QUESTIONS ABOUT ANYTHING YOU DO NOT UNDERSTAND.
1. Complete this Statement of Understanding only after you have carefully thought about the
permanent placement of this child and you are sure that you want this child adopted by the
petitioner(s) and raised by him/her/them.
2. Read each of the statements in this document very carefully. If you do not understand a
statement, ask the agency representative to explain it to you until you completely understand.
3. If you understand and agree with a statement, put your initials on the line next to the number of
that statement.
4. If you do not agree, or if you do not understand a statement after the agency representative’s
explanation, do not initial the line. Ask for more help and time in making your decision.
5. If you have initialed all the lines, sign your name on page 3 of this form.
6. You will receive a copy of this Statement of Understanding and the consent to adoption form when
it has been completed.
THIS FORM MUST BE USED WITH ONE OF THE FOLLOWING CONSENT FORMS:
AD 594 OR AD 842
AD 887B (7/17) ALLEGED FATHER
PAGE 1 OF 4
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