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Here is the text we could read:

JV-321

Request for Prospective Adoptive
Parent Designation

Clerk stamps date here when form is filed.

After filling out this form, bring it to the clerk of the court. If you want to keep
an address or telephone number confidential, do not write that information on
this form. Instead, include that information in Confidential Information—
Prospective Adoptive Parent (form JV-322).

Information about the person or persons you want to be designated as
prospective adoptive parents:

Fill in court name and street address:

Superior Court of California, County of

Name:

City:

Street address:

Telephone number:

Name:

I am the
(specify role):

Street address:

City:

Telephone number:

State:

Zip:

If you are not a person in , fill out below.

child

child’s attorney

other

State:

Zip:

Fill in child's name and date of birth:

Child's Name:

Date of Birth:

Fill in case number:

Case Number:

If you are not the child’s attorney and you know who the child’s attorney is, fill out below.

Name of child’s attorney:

Street address of child’s attorney:

c. City:

State:

Zip:

Telephone number of child’s attorney:

The child is 10 years of age or older. Child’s telephone number:
or

Telephone number is confidential.

The child has lived with the person from (date): to the present.
In order for the person in to become a prospective adoptive parent, the child must be living with that person
now.

6 Date of Welfare and Institutions Code section 366.26 hearing:

The person in should not file this form with the court until a Welfare and Institutions Code section 366.26
1
hearing has been scheduled.

The person in is committed to adopting the child.

Judicial Council of California, www.courts.ca.gov
Rev. September 1, 2020, Mandatory Form
Welfare & Institutions Code, §§ 366.24, 366.26(n)
Cal. Rules of Court, rule 5.726

Request for Prospective Adoptive
Parent Designation

JV-321, Page 1 of 2

Child’s name:

Case Number:

The person in has (check all that apply):
a.
b.

Applied for an adoptive home study.
In a case in which tribal customary adoption is the permanent plan, been identified by the Indian child’s
tribe as the prospective adoptive parent.
Cooperated with an adoptive home study.
Signed an adoptive placement agreement.
Requested de facto parent status.
Been designated by the juvenile court or the licensed adoption agency as the adoptive parent.
Discussed a postadoption contact agreement with the social worker, child’s attorney, child’s Court
Appointed Special Advocate (CASA) volunteer, adoption agency, or court.
Worked to overcome any impediments that have been identified by the California Department of Social
Services or the licensed adoption agency.
Attended any of the classes required of a prospective adoptive parent.
Taken other steps toward adopting the child (explain):

c.
d.
e.
f.
g.

i.
j.

If you need more space, attach a sheet of paper and write “JV-321, Item 8—Steps Toward Adoption” at the
top. Number of pages attached:

I declare under penalty of perjury under the laws of the State of California that the information in items 1 through 8 is true
and correct, which means if I lie on this form, I am committing a crime.

Date:

Type or print your name

Sign your name

NOTICE

If you are not the child, child’s parent, or child’s legal guardian, you may have a right to challenge a decision by the
juvenile court, but only in very limited circumstances. You may need a court order granting you access to records in the
juvenile case file. For more information, please see Information on Requesting Access to Records for Persons With a
Limited Right to Appeal (form JV-291-INFO). You can get form JV-291-INFO at any courthouse or county law library
or online at www.courts.ca.gov/forms.

Rev. September 1, 2020

Request for Prospective Adoptive
Parent Designation

JV-321, Page 2 of 2

Request for Prospective Adoptive Parent Designation

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 50
Average fields per page: 25
Reading Level: Grade 7
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

j_page_right_court_info_ft was JV-321[0].Page1[0].RightCaption[0].CourtInfo_ft[0] (0.52 conf)
j_page_right_child_name_ft was JV-321[0].Page1[0].RightCaption[0].ChildName_ft[0] (0.36 conf)
j_v_page_right_date_birth was JV-321[0].Page1[0].RightCaption[0].DateBirth[0] (0.34 conf)
j_v_page_name_ft__1 was JV-321[0].Page1[0].Name_ft[0] (0.28 conf)
j_v_page_case_number_ft__1 was JV-321[0].Page1[0].CaseNumber_ft[0] (0.34 conf)
j_v_page_phone_ft__1 was JV-321[0].Page1[0].Phone_ft[0] (0.30 conf)
j_v_page_item_area_cb was JV-321[0].Page1[0].item4[0].#area[0].item4_cb[0] (0.35 conf)
j_v_page_item_area_phone_tf was JV-321[0].Page1[0].item4[0].#area[0].item4phone_tf[0] (0.35 conf)
j_v_page_name_ft__2 was JV-321[0].Page1[0].Name_ft[1] (0.28 conf)
j_v_page_street_address_ft__1 was JV-321[0].Page1[0].StreetAddress_ft[0] (0.31 conf)
j_v_page_text_field__1 was JV-321[0].Page1[0].TextField[0] (0.31 conf)
j_v_page_text_field__2 was JV-321[0].Page1[0].TextField[1] (0.31 conf)
j_v_page_text_field__3 was JV-321[0].Page1[0].TextField[2] (0.31 conf)
j_v_page_name_ft__3 was JV-321[0].Page1[0].Name_ft[2] (0.28 conf)
j_v_page_check_box_right__1 was JV-321[0].Page1[0].CheckBoxRightCaption[0] (0.39 conf)
j_v_page_check_box_right__2 was JV-321[0].Page1[0].CheckBoxRightCaption[1] (0.39 conf)
j_v_page_check_box_right__3 was JV-321[0].Page1[0].CheckBoxRightCaption[2] (0.39 conf)
j_v_page_text_field__4 was JV-321[0].Page1[0].TextField2[0] (0.31 conf)
j_v_page_phone_ft__2 was JV-321[0].Page1[0].Phone_ft[1] (0.30 conf)
j_v_page_street_address_ft__2 was JV-321[0].Page1[0].StreetAddress_ft[1] (0.31 conf)
j_v_page_text_field__5 was JV-321[0].Page1[0].TextField[3] (0.31 conf)
j_v_page_text_field__6 was JV-321[0].Page1[0].TextField[4] (0.31 conf)
j_v_page_text_field__7 was JV-321[0].Page1[0].TextField[5] (0.31 conf)
j_v_page_name_ft__4 was JV-321[0].Page1[0].Name_ft[3] (0.28 conf)
j_v_page_phone_ft__3 was JV-321[0].Page1[0].Phone_ft[2] (0.30 conf)
j_v_page_street_address_ft__3 was JV-321[0].Page1[0].StreetAddress_ft[2] (0.31 conf)
j_v_page_text_field__8 was JV-321[0].Page1[0].TextField[6] (0.31 conf)
j_v_page_text_field__9 was JV-321[0].Page1[0].TextField[7] (0.31 conf)
j_v_page_text_field__10 was JV-321[0].Page1[0].TextField[8] (0.31 conf)
j_v_page_confi_phone_cb was JV-321[0].Page1[0].ConfiPhone_cb[0] (0.30 conf)
j_v_page_date_field__1 was JV-321[0].Page1[0].DateField1[0] (0.31 conf)
j_v_page_date_field__2 was JV-321[0].Page1[0].DateField2[0] (0.31 conf)
j_v_page_check_box_right__4 was JV-321[0].Page1[0].CheckBoxRightCaption[3] (0.39 conf)
j_v_page_text_field__11 was JV-321[0].Page2[0].TextField2[0] (0.31 conf)
j_v_page_case_number_ft__2 was JV-321[0].Page2[0].PxCaption[0].CaseNumber_ft[0] (0.37 conf)
j_v_page_child_name_ft was JV-321[0].Page2[0].ChildName_ft[0] (0.34 conf)
j_v_page_check_box_right__5 was JV-321[0].Page2[0].CheckBoxRightCaption[0] (0.39 conf)
j_v_page_check_box_right__6 was JV-321[0].Page2[0].CheckBoxRightCaption[1] (0.39 conf)
j_v_page_check_box_right__7 was JV-321[0].Page2[0].CheckBoxRightCaption[2] (0.39 conf)
j_v_page_check_box_right__8 was JV-321[0].Page2[0].CheckBoxRightCaption[3] (0.39 conf)
j_v_page_check_box_right__9 was JV-321[0].Page2[0].CheckBoxRightCaption[4] (0.39 conf)
j_v_page_check_box_right__10 was JV-321[0].Page2[0].CheckBoxRightCaption[5] (0.39 conf)
j_v_page_check_box_right__11 was JV-321[0].Page2[0].CheckBoxRightCaption[6] (0.39 conf)
j_v_page_sig_date was JV-321[0].Page2[0].SigDate[0] (0.30 conf)
j_v_page_sig_name__1 was JV-321[0].Page2[0].SigName[0] (0.30 conf)
j_v_page_check_box_right__12 was JV-321[0].Page2[0].CheckBoxRightCaption[7] (0.39 conf)
j_v_page_check_box_right__13 was JV-321[0].Page2[0].CheckBoxRightCaption[8] (0.39 conf)
j_v_page_check_box_right__14 was JV-321[0].Page2[0].CheckBoxRightCaption[9] (0.39 conf)
j_v_page_text_field__12 was JV-321[0].Page2[0].TextField2[1] (0.31 conf)
j_v_page_sig_name__2 was JV-321[0].Page2[0].SigName[1] (0.30 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Request for Prospective Adoptive Parent Designation

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02