Form Ad 900b - Statement Of Understanding - Alleged Father Of An Indian Child Page 4
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6STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
TO BE COMPLETED BY THE ALLEGED FATHER WHEN THE CHILD HAS NOT BEEN CONFIRMED
AS COVERED UNDER ICWA
_____ 7.
ALLEGED FATHER WILL ONLY INITIAL THE BELOW STATEMENTS IF the child has not been
confirmed as covered under ICWA.
_____ a. I understand that if this child is later determined NOT to be subject to the ICWA, then the
below rights described in (1) and (2) will apply to this child and the above rights numbers
3 through 6 will not apply to this child.
_____ (1) I understand the other legal parent(s) consent to adoption form will
automatically become an irrevocable consent to adoption when the 30-day
period has ended, or after they have 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 consent to adoption form is signed by the legal parent.
_____ (2) After the consent to adoption form becomes irrevocable, the other legal
parent(s) may regain custody of the child only if the petitioner(s) agree(s) to
withdraw his/her/their petition for adoption, or if the court denies the adoption
petition.
_____ b. I understand that if this child is later confirmed as covered under the ICWA, then the
investigating agency will notify me and the rights described in numbers 3 through 6, will
apply. I understand I must keep the agency informed of my current address.
RIGHTS IN EVERY CASE
_____ 8.
I understand that if I do not wish to have my child adopted by the petitioner(s), I should not sign
this form the consent to adoption form and I must establish paternity.
_____ 9.
I understand I have the right to look for a lawyer or that the adoption agency can refer me to public
legal help in my community to assist me in any of the following:
a. To help me in the independent adoption process.
b. To get a court order that says I am this child’s father and gives me physical custody of this child.
c. To help me argue against the petitioner(s) having my parental rights terminated if I choose not to
sign this Statement of Understanding and consent to adoption form.
_____ 10. I understand if I want to raise this child and I am successful in proving I am the father of this child in
court and get physical custody of this child there are:
a. Temporary arrangements I can make for this child which include child care, placing this child
with friends or relatives, or foster care;
b. Services to help this child and me learn to have a father and child relationship; and
c. Other agencies that could help me with family, health, money, and other problems.
_____ 11. I understand I may talk about the plan of adoption for this child with other professional people, my
family, and friends.
AD 900B (5/17) ALLEGED FATHER OF INDIAN CHILD
PAGE 4 OF 6
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