§ 35001. Definitions - Forms.

The following forms, which are incorporated by reference, apply to the regulations in Title 22, Division 2, Subdivision 4, Chapter 3 (Adoption Program Regulations).

(a)(1) “AAP 1” (9/09) means the form entitled, “Request for Adoption Assistance Program Benefit.”

(2) “AAP 2” (7/11) means the form entitled, “Payment Instructions - Adoption Assistance Program.”

(3) “AAP 3” (7/11) means the form entitled, “Reassessment Information - Adoption Assistance Program.”

(4) “AAP 4” (11/11) means the form entitled, “Eligibility Certification - Adoption Assistance Program.”

(5) “AAP 6” (11/11) means the form entitled, “Adoption Assistance Program - Negotiated Benefit Amount and Approval and Form Instructions.”

(6) “AAP 8” (11/11) means the form entitled, “Adoption Assistance Program - Nonrecurring Adoption Expenses Agreement.”

(7) “AD 1A” (1/95) means the form entitled, “Consent to Adoption by Parent(s) in California.”

(8) “AD 1C” (1/95) means the form entitled, “Consent to Adoption by Parent(s) Outside California.”

(9) “AD 1F” (1/95) means the form entitled, “Consent to Adoption by Parent(s) Outside California in Armed Forces.”

(10) “AD 20” (2/93) means the form entitled, “Refusal to Give Consent to Adoption.”

(11) “AD 20B” (4/92) means the form entitled, “Refusal to Give Consent to Adoption by Alleged Natural Father.”

(12) “AD 42 I” (7/95) means the form entitled, “Independent Adoption Program - Individual Case Report.”

(13) “AD 42 ICA” (7/95) means the form entitled, “Intercountry Adoption Program - Individual Case Report.”

(14) “AD 42R” (7/95) means the form entitled, “Relinquishment Adoption Program - Individual Case Report.”

(15) “AD 67” (6/95) means the form entitled, “Information About the Birth Mother.”

(16) “AD 67A” (6/95) means the form entitled, “Information About the Birth Father.”

(17) “AD 90” (1/94) means the form entitled, “Supporting Information for Issuance of Department of Social Services Acknowledgment.”

(18) “AD 100” (12/93) means the form entitled, “Authorization for Release of Information.”

(19) “AD 165” (1/95) means the form entitled, “Consent to Adoption by Parent in California When Legal Father Denies He is the Natural Father.”

(20) “AD 166” (1/95) means the form entitled, “Consent to Adoption by Father Outside California.”

(21) “AD 501 ENG/SP” (12/91) means the form entitled, “Relinquishment (Birth Mother and/or Presumed Father).”

(22) “AD 501A ENG/SP” (12/91) means the form entitled, “Relinquishment (Out of State).”

(23) “AD 503 ENG/SP” (12/91) means the form entitled, “Relinquishment - Out of County (Birth Mother and/or Presumed Father).”

(24) “AD 504” (12/91) means the form entitled, “Relinquishment - Out of State - in-Armed Forces.”

(25) “AD 508 (3/82) means the form entitled, Rescission Request/Rescission of Relinquishment.”

(26) “AD 512” (7/98) means the form entitled, “Psychosocial and Medical History of Child.”

(27) “AD 551A” (3/94) means the form entitled, “Notification of Procedure in Lieu of Signing Relinquishment Waiver or Denial.”

(28) “AD 558” (8/97) means the form entitled, “Notice of Placement.”

(29) “AD 580” (6/97) means the form entitled, “Notice of Removal of Child from Adoptive Home.”

(30) “AD 583 Eng/Sp” (6/95) means the form entitled, “Relinquishment - Out of County (Presumed Father Denies He is the Birth Father).”

(31) “AD 584 Eng/Sp” (8/95) means the form entitled, “Relinquishment - Out of State (Presumed Father Denies He is the Birth Father).”

(32) “AD 585 Eng/Sp” (8/95) means the form entitled, “Relinquishment (Presumed Father Denies He is the Birth Father).”

(33) “AD 586 Eng/Sp” (6/97) means the form entitled, “Relinquishment - In or Out of County (Alleged Natural Father in California).”

(34) “AD 588 Eng/Sp” (6/98) means the form entitled, “Denial of Paternity by Alleged Natural Father - In or Out of California.”

(35) “AD 590 Eng/Sp” (6/98) means the form entitled, “Waiver of Right to Further Notice of Adoption Planning (Alleged Natural Father In or Out of California).”

(36) “AD 591 Eng/Sp” (12/91) means the form entitled, “Relinquishment (Alleged Natural Father) Out of State or County.”

(37) “AD 593” (12/91) means the form entitled, “Relinquishment (Alleged Natural Father) Outside of California in Armed Forces.”

(38) “AD 594” (1/95) means the form entitled, “Consent to Adoption by Alleged Natural Father.”

(39) “AD 824” (5/97) means the form entitled, “Consent and Joinder” for agency adoptions.

(40) “AD 830” (9/97) means the form entitled, “Summary Claim for Reimbursement Private Adoption Agency Reimbursement Program.”

(41) “AD 831” (7/87) means the form entitled, “Private Adoption Agency Cost Justification for Adoptive Placement.”

(42) “AD 842” (1/95) means the form entitled, “Consent to Adoptive Placement by Alleged Natural Father (Outside California in Armed Forces).”

(43) “AD 859” (1/95) means the form entitled, “Consent to Adoption of Indian Child by Parent(s) in or out of California.”

(44) “AD 860” (1/95) means the form entitled, “Consent to Adoption of Indian Child by Presumed Father in or out of California.”

(45) “AD 861” (6/95) means the form entitled, “Consent to Adoption of Indian Child by Alleged Natural Father (In or Outside of California).”

(46) “AD 862” (12/91) means the form entitled, “Relinquishment of Indian Child by Alleged Natural Father - Out of State or County.”

(47) “AD 863” (12/91) means the form entitled, “Relinquishment of Indian Child - Out of State.”

(48) “AD 864” (1/92) means the form entitled, “Relinquishment of Indian Child (Birth Mother and/or Presumed Father).”

(49) “AD 865” (1/92) means the form entitled, “Relinquishment of Indian Child (Birth Mother and/or Presumed Father) Out of County.”

(50) “AD 866” (8/95) means the form entitled, “Relinquishment of Indian Child (Presumed Father Denies He is the Birth Father).”

(51) “AD 867” (6/95) means the form entitled, “Relinquishment of Indian Child (Presumed Father Denies He is the Birth Father) Out of State.”

(52) “AD 868” (1/92) means the form entitled, “Relinquishment of Indian Child (Alleged Natural Father in California) In/Out of County.”

(53) “AD 873” (7/95) means the form entitled, “Relinquishment of Indian Child (Presumed Father Denies He is Birth Father) Out of County.”

(54) “AD 880” (7/98) means the form entitled, “Declaration of Mother.”

(55) “AD 885” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Mother or a Presumed Father of the Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(56) “AD 885A” (9/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Mother or a Presumed Father of a Child Who Is Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(57) “AD 885C” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Alleged Natural Father of the Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(58) “AD 885D” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Alleged Natural Father of the Child Who Is Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(59) “AD 887” (3/97) means the form entitled, “Statement of Understanding - Independent Adoptions Program (Parent Who Gave Physical Custody of the Child to the Adoptive Parents).”

(60) “AD 887A” (3/97) means the form entitled, “Statement of Understanding - Independent Adoptions Program (Parent Who Did Not Give Physical Custody of the Child to the Adoptive Parents).”

(61) “AD 887B” (3/97) means the form entitled, “Statement of Understanding - Independent Adoptions Program (Alleged Natural Father).”

(62) “AD 899” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Mother or a Presumed Father of the Indian Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(63) “AD 899A” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Mother or a Presumed Father of an Indian Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(64) “AD 899C” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Alleged Natural Father of the Indian Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(65) “AD 899D” (7/98) means the form entitled, “Statement of Understanding - Agency Adoptions Program (Alleged Natural Father of the Indian Child Who Is Not Detained, a Juvenile Court Dependent in Out-of-Home Care, or the Ward of a Legal Guardian).”

(66) “AD 900” (1/95) means the form entitled, “Statement of Understanding - Independent Adoptions Program (Parent Who Gave Physical Custody of the Indian Child to the Adoptive Parents).”

(67) “AD 900A” (1/95) means the form entitled, ”Statement of Understanding - Independent Adoptions Program (Parent Who Did Not Give Physical Custody of the Indian Child to the Adoptive Parents).”

(68) “AD 900B” (1/95) means the form entitled, “Statement of Understanding - Independent Adoptions Program (Alleged Natural Father of Indian Child).”

(69) “AD 904” (2/94) means the form entitled, “Consent for Contact.”

(70) “AD 904A” (1/94) means the form entitled, “Waiver of Rights to Confidentiality of Adoption Records for Siblings.”

(71) “AD 907” (5/94) means the form entitled, “Adoptive Placement Agreement.”

(72) “AD 908 Eng/Sp” (1/98) means the form entitled, “Adoptions Information Act Statement.”

(73) “AD 909” (8/88) means the form entitled, “Photolisting Data Sheet.”

(74) “AD 920 Eng/Sp” (2/93) means the form entitled, “Relinquishment - In or Out of County (Alleged Natural Father In California) - Parent Identifying Adopting Parent(s).”

(75) “AD 921 Eng/Sp” (1/93) means the form entitled, “Relinquishment (Birth Mother and/or Presumed Father) - Parent Identifying Adopting Parent(s).”

(76) “AD 922 Eng/Sp” (3/97) means the form entitled, “Relinquishment Addendum for Parent Identifying Adopting Parent(s).”

(77) “AD 924” (3/95) means the form entitled, “Independent Adoption Placement Agreement.”

(78) “AD 925” (1/95) means the form entitled, “Independent Adoption Placement Agreement - Indian Child.”

(79) “AD 926” (3/97) means the form entitled, “Statement of Understanding - Independent Adoption Program (Parent Who Signs Independent Adoption Placement Agreement).”

(80) “AD 927” (1/95) means the form entitled, “Statement of Understanding - Independent Adoption Program (Parent of Indian Child Who Signs Independent Adoption Placement Agreement).”

(81) “AD 928” (3/97) means the form entitled, “Revocation of Consent - Independent Adoption Program.”

(82) “AD 929” (5/97) means the form entitled, “Waiver of Right to Revoke Consent - Independent Adoption Program.”

(83) “AD 930” (1/95) means the form entitled, “Independent Adoption Placement Agreement Transmittal.”

(84) “AD 4310” (1/93) means the form entitled, “Adoption Programs Notice Required by Information Practices Act.”

(85) “AD 4311” (1/98) means the form entitled, “Information on American Indian Child (Adoption Program).”

(86) “AD 4317” (3/82) means the form entitled, “Revocation of Relinquishment.”

(87) “AD 4320” (11/11) means the form entitled, “Adoption Assistance Program Agreement.”

(88) “AD 4333” (6/96) means the form entitled, “Acknowledgement and Confirmation of Receipt of Relinquishment Documents.”

(89) “AD 4336” (4/97) means the form entitled, “Consent to Adoption by Presumed Father in Armed Forces - Outside of California, Denies He is Natural Father.”

(b)(1) “BID 7-A” (5/90) means the fingerprint card.

(c) Reserved

(d)(1) DHS 6155 (10/90) means the form entitled “Health Insurance Questionnaire.”

(e) Reserved

(f)(1) (Reserved)

(f)(2) (Reserved)

(3) “(FC 3)” (2/92) means the form entitled, “Determination of Federal AFDC-FC Eligibility.”

(4) (Reserved)

(5) (Reserved)

(6) (Reserved)

(7) (Reserved)

(8) “FC 8” (7/11) means the form entitled, “Federal Eligibility Certification for Adoption Assistance Program.”

(9) (Reserved)

(10) “FC 10” (8/09) means the form entitled, “Income and Property Checklist for Federal Eligibility Determination - Adoption Assistance Program.”

(g) Reserved

(h) Reserved

(i)(1) “ICPC 100A” (10/91) means the form entitled, “Interstate Compact Application Request to Place Child.”

(2) “ICPC 100B” (7/92) means the form entitled, “Interstate Compact Report on Child's Placement Status.”

(3) “I-600” (5/83) means the form entitled, “Petition to Classify Orphan as an Immediate Relative.”

(j) Judicial Council Forms to Finalize Adoptions

(1) “Adopt-200” (1/99) means the form entitled, “Petition for Adoption.”

(2) “Adopt-210” (1/99) means the form entitled, “Petitioner Consent and Agreement to Adoption.”

(3) “Adopt-215 (1/99) means the form entitled, “Order of Adoption.”

(4) “Adopt-220” (1/99) means the form entitled, “Attachment to Petition for Adoption - Adoption of an Indian Child.”

(5) “Adopt-230” (1/99) means the form entitled, “Accounting Report - Adoptions.”

(6) “Adopt-310 (1/99) means the form entilted, “Kinship Adoption Agreement.”

(7) “JV-505” (1/99) means the form entitled, “Statement Regarding Paternity” (Juvenile Dependency).

(k)-(u) Reserved

(v)(1) “VS 44” (1/91) means teh form entitled, “Court Report of Adoption.”

(w)-(z) Reserved

HISTORY

1. Renumbering of former section 35001 to section 35002 and new section filed 9-8-93; operative 10-7-93 (Register 93, No. 37). For prior history, see Register 91, No. 52.

2. New subsections (a)(1)-(4) and subsection renumbering, new subsection (a)(48), reservation of subsections (b)-(f)(2), new subsection (f)(3), reservation of subsections (f)(4)-(7), new subsections (f)(8)-(10) and amendment of Note filed 10-31-94 as an emergency; operative 11-1-94 (Register 94, No. 44). A Certificate of Compliance must be transmitted to OAL by 3-1-95 or emergency language will be repealed by operation of law on the following day.

3. New subsections (a)(5)-(9), (a)(12), (a)(14)-(15), (a)(20), (a)(23)-(25), (a)(34)-(40), (a)(49), (a)(64)-(65), (a)(69)-(78) and (b)-(z), subsection renumbering, amendment of redesignated subsections (a)(13), (a)(54)-(56), (a)(61)-(63), repealer of subsection (a)(44), and amendment of Note filed 12-29-94; operative 1-1-95 (Register 94, No. 52).

4. Editorial correction of subsection renumbering (Register 95, No. 6).

5. Editorial correction of History 3 and inserting inadvertently omitted History 4 (Register 95, No. 13).

6. Change without regulatory effect adding new subsection (a)(80) filed 3-27-95 pursuant to section 100, title 1, California Code of Regulations (Register 95, No. 13).

7. Certificate of Compliance as to 10-31-94 order including amendment of section transmitted to OAL 2-27-95 and filed 4-10-95 (Register 95, No. 15).

8. Amendment filed 7-30-98 as an emergency; operative 8-1-98 (Register 98, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-30-98 or emergency language will be repealed by operation of law on the following day.

9. Amendment refiled 11-24-98 as an emergency; operative 11-29-98 (Register 98, No. 48). A Certificate of Compliance must be transmitted to OAL by 3-29-99 or emergency language will be repealed by operation of law on the following day.

10. Certificate of Compliance as to 11-24-98 order, including amendment of section, transmitted to OAL 3-25-99 and filed 5-3-99 (Register 99, No. 19).

11. Amendment of subsections (a)(1), (a)(3) and (a)(85) filed 11-30-2000 as an emergency; operative 12-1-2000 (Register 2001, No. 13). A Certificate of Compliance must be transmitted to OAL by 3-30-2001 or emergency language will be repealed by operation of law on the following day.

12. Amendment of subsections (a)(1), (a)(3) and (a)(85) refiled 3-30-2001 as an emergency; operative 3-31-2001 (Register 2001, No. 13). A Certificate of Compliance must be transmitted to OAL by 7-30-2001 or emergency language will be repealed by operation of law on the following day.

13. Certificate of Compliance as to 3-31-2001 order, including further amendment of subsections (a)(1), (a)(3) and (a)(85), transmitted to OAL 7-27-2001 and filed 9-6-2001 (Register 2001, No. 36).

14. Amendment of subsections (a)(1)-(4), new subsections (a)(5)-(6), subsection renumbering and amendment of newly designated subsection (a)(87) and subsections (f)(8) and (f)(10) filed 11-10-2011; operative 12-10-2011 (Register 2011, No. 45).

Note

Note: Authority cited: Sections 10553, 10554, 16118 and 16120, Welfare and Institutions Code; and Section 8621, Family Code. Reference: Sections 16105, 16118 and 16120.05, Welfare and Institutions Code; Sections 8500 et seq., 8600 et seq., 8700 et seq., 8800 et seq., 8900 et seq., 9100 et seq. and 9200 et seq., Family Code.