1 [TYPE YOUR NAME HERE] 2 [TYPE YOUR ADDRESS HERE] 3 [TYPE YOUR CITY, STATE AND ZIP HERE] 4 [TYPE YOUR PHONE NUMBER HERE] In Propria Persona 5 6 7 8 9 SUPERIOR COURT OF CALIFORNIA COUNTY OF [TYPE YOUR COUNTY HERE] 10 In the matter of the Adoption ) Case No.: [TYPE THE CASE NUMBER 11 Request of [TYPE YOUR NAME ) HERE] HERE], ) 12 on Behalf of ) Notice to Alleged Father [TYPE THE NAME OF THE ADOPTEE ) 13 HERE], ) a minor 14 15 TO: [TYPE THE NAME OF THE ALLEGED FATHER HERE], alleged father: 16 1. YOU ARE HEREBY GIVEN NOTICE that it is alleged that you 17 are, or could be, the natural father of [TYPE CHILD’S NAME 18 19 HERE], born on [TYPE CHILD’S DATE OF BIRTH HERE] to [TYPE 20 MOTHER’S NAME HERE].

21 2. [TYPE MOTHER’S NAME HERE] desires to place the child for 22 stepparent adoption. An adoption has been filed in the [TYPE 23 NAME OF COUNTY HERE] County Superior Court, Case No. [TYPE CASE 24 NUMBER HERE]. An adoption hearing is scheduled for [TYPE DATE OF 25 26 HEARING HERE].

27 3. If you fail to bring an action for the purpose of

28 declaring the existence of a parent and child relationship pursuant to Section 7630 and Section 7664(b) of the California 1 2 Family Code within thirty (30) days of service of this Notice, 3 you will not be given further notice of the adoption proceeding

4 and your parental rights, if any, will be terminated. 5 4. If you wish to agree to the adoption, waive notice of 6 further proceedings in the adoption and/or deny paternity of the 7 child, please sign any or all of the appropriate items below and 8 9 return this document in the attached prepaid envelope provided 10 with this Notice. If you sign any of these items, you must have

11 this document notarized. If you have any questions, contact the 12 undersigned at [TYPE YOUR PHONE NUMBER HERE]. If you wish to 13 bring an action to establish a parental relationship as 14 15 described above, you should seek the advice of an attorney 16 immediately. 17

18 Dated: [TYPE THE DATE HERE] 19 20 ______21 22 [TYPE YOUR NAME HERE AND SIGN ON THE LINE ABOVE] 23

24 1. I have received this notice. 25 Dated: ______26 [TYPE THE ALLEGED FATHER’S NAME HERE] 27 28 2. I deny paternity of the minor child and I waive further 1 2 notice of the adoption proceeding. 3 Dated: ______

4 [TYPE THE ALLEGED FATHER’S NAME HERE] 5 3. I agree with the adoption plan for the minor child and 6 waive all parental rights to the child I may have, and do not 7 want further notice of the adoption proceeding (please also sign 8 9 attached Waiver form). 10 Dated: ______

11 [TYPE THE ALLEGED FATHER’S NAME HERE] 12 13 State of California ) 14 15 ) 16 County of ______)

17 On ______, before me, ______, personally appeared [TYPE THE NAME OF THE ALLEGED FATHER HERE], 18 personally known to me or proved to me on the basis of 19 satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed 20 the same, and that by his signature on the instrument the person executed the instrument. 21 22 Witness my hand and official seal. Signature ______23 24 25 26 27 28