Form Ad 887b - Statement Of Understanding - Alleged Natural Father Page 4
Download a blank fillable Form Ad 887b - Statement Of Understanding - Alleged Natural Father 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 887b - Statement Of Understanding - Alleged Natural Father 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
4STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
SECTION A:
Complete if signed in California
I, ___________________________________________________________________ , an authorized official
NAME OF AUTHORIZED AGENCY OFFICIAL
of __________________________________________________________, have witnessed the signing of this
NAME OF AGENCY
Statement of Understanding by ____________________________________________ on _______________
NAME OF ALLEGED NATURAL FATHER
DATE
SIGNATURE OF AUTHORIZED AGENCY
TITLE
FULL ADDRESS
TELEPHONE NUMBER
SECTION B:
Complete if signed outside of California *
*** THIS FORM MUST BE SIGNED BY A NOTARY PUBLIC WHEN SIGNED OUTSIDE OF CALIFORNIA***
The Notary Public must staple the Acknowledgement document to this form and sign and date below.
DATE:
SIGNATURE OF NOTARY
* If signing outside of the United States, this section must meet the requirements of California Civil
Code Section 1183
.
Signed (pursuant to California Civil Code Section 1183.5) in the presence of:
On this the _____ day of ________________, 20 _____ before me, _________________________________,
NAME OF OFFICER
the undersigned officer, personally appeared ____________________________________ known to me (or
NAME OF PARENT
satisfactorily proven) to be:
1) Serving in the armed forces of the United States,
2) A spouse of a person serving in the armed forces of the United States, or
3) A person serving with, employed by, or accompanying the armed forces of the United States outside the
United States and outside the Canal Zone, Puerto Rico, Guam, and the Virgin Islands.
The parent is aldo know to me (or satisfactory proven)and to be the person whose name is subscribed to the
within instrument and acknowledged that he executed the same. I certify that he is at the date of this
certificate a commissioned officer of the armed forces of the United States having the general powers of a
notary public under the provisions of Section 936 or 1044a of Title 10 of the United States Code (Public Law
90-632 and 101-510).
Subscribed and sworn to before me on this ________ day of ____________________, 20 ____ .
RANK AND SERIAL NUMBER
SIGNATURE OF OFFICER
CAPACITY IN WHICH SIGNED
BRANCH OF SERVICE
AD 887B (7/17) ALLEGED FATHER
PAGE 4 OF 4
ADVERTISEMENT
0 votes
Related Articles
Related forms
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
Form Ad 887 - Statement Of Understanding - Parent Who Gave Physical Custody Of The Child To The Petitioner(s)
Legal
Form Ad 927 - Statement Of Understanding - Parent Who Places The Indian Child With The Prospective Adoptive Parent(s)
Legal
Related Categories
Parent category: Legal