ADOPT-330 - Request for Appointment of Confidential Intermediary

Summary

Request for Appointment of Confidential Intermediary

Text

Form ID: ADOPT-330
Title: Request for Appointment of Confidential Intermediary
Effective Date: 2024-01-01
Mandatory Form: yes
Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADOPT-330
Primary Download URL: https://www.courts.ca.gov/documents/adopt330.pdf
Form Detail Page:
Request for Appointment of Confidential Intermediary
(ADOPT-330)
Asks the court to appoint someone (Confidential Intermediary) to help you ask for your sibling's contact information after you or your sibling has been adopted.  This form cannot be completed by you unless you have already asked the Department of Social Services for this information and you did not get that information.
Get form ADOPT-330
Effective: January 1, 2024
Go to
How-to instructions for Adoption
Go to
Adoption Form Packets
PDF Text:
Judicial Council of California, www.courts.ca.gov 
Revised January 1, 2024, Mandatory Form 
Code Civ. Proc., § 373 
Fam. Code, § 9205 
Cal. Rules of Court, rule 5.460
Request for Appointment of 
Confidential Intermediary
ADOPT-330 Request for Appointment of 
Confidential Intermediary
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Use this form if you are seeking contact with your sibling who is not currently a 
dependent of the court and one of you has been adopted. If your sibling is 
currently a dependent of the court, you must follow the procedure in Welfare 
and Institutions Code section 388(b) instead of using this form.
Before completing this form, you must ask for contact with your sibling from the 
department or licensed adoption agency that joined in your adoption or your 
sibling's adoption. If you do not know the name of the department or agency, 
ask the California Department of Social Services, Adoption Services Branch, 
916-651-8089.
After filling out this form, bring it and a blank copy of the proposed Order 
(ADOPT-331) to the clerk of the court where the adoption was finalized. After 
the court signs the order, a copy of this Request and the Order will be 
forwarded to the California Department of Social Services or the adoption 
agency, as designated by the court, and copies will be given to you.
1 I am asking the court to appoint a confidential intermediary to help me get 
contact information for my sibling.
a. My name:
b. My address:
c. My phone number:
2 a. The person helping me complete this request for the appointment of a confidential intermediary is:
(1) Name:
My attorney (State Bar No. ) My guardian ad litem
(2) Address:
(3) Phone number:
b. I do not have an attorney or guardian ad litem who is helping me complete this request for the appointment of a 
confidential intermediary.
3 An attorney used to represent me.
a. Name of former attorney:
b. Address of attorney:
c. Phone number of attorney:
d. This attorney used to represent me because:
4 The department or the licensed adoption agency that joined in the adoption petition for:
me
my sibling
a. Name of agency:
b. Address:
c. Phone number:
ADOPT-330, Page 1 of 2

Rev. January 1, 2024 Request for Appointment of 
Confidential Intermediary
Your name:
Case Number:
5 The sibling whom I would like to contact is:
a. My sibling’s name:
b. My sibling’s current address (if known):
c. My sibling is under the age of 18 years.
(2) My sibling used to live with (name and relationship to my sibling, if known):
(1) My sibling currently lives with (name and relationship to my sibling, if known):
6 My sibling was adopted in this county: Yes No Unknown
7 My sibling was previously a dependent of the court in this county: Yes No Unknown
8 The following are true (check all that apply):
a. I submitted a written California Department of Social Services waiver form AD 904A or AD 904B to 
the agency listed in      before I completed this form.4
b. The agency in      sent a letter to me stating that no waiver for my sibling is in its file. 
A copy of the letter from the agency is attached to this request.
4
c. I am asking the court to appoint a confidential intermediary to help me get contact information for my 
sibling.
d. I am under the age of 18 years.
(1) My parent/guardian signed a consent giving me permission to contact my sibling: Yes No
(2) The court signed a consent giving me permission to contact my sibling: Yes No
e. My sibling is under the age of 18 years.
f. To the best of my knowledge, there is not now, and never has been, an order stating that I cannot have 
contact with the sibling named in      .5
9 Any other information that would be helpful to the court:
I declare under penalty of perjury under the laws of the State of California that the information in items 1 through 9, 
and in all attachments, is true and correct, which means that if I lie on this form, I am committing a crime.
Date:
Type or print your name
 Sign your name
Date:
Type or print your name
 Signature 
Attorney Guardian ad litem
ADOPT-330, Page 2 of 2
Person who helped the applicant complete the form:

Retrieval chunks

• #1

  Form ID: ADOPT-330 Title: Request for Appointment of Confidential Intermediary Effective Date: 2024-01-01 Mandatory Form: yes Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADOPT-330 Primary Download URL: https://www.courts.ca.gov/documents/adopt330.pdf Form Detail Page: Request for Appointment of Confident…

• #2

  2 a. The person helping me complete this request for the appointment of a confidential intermediary is: (1) Name: My attorney (State Bar No. ) My guardian ad litem (2) Address: (3) Phone number: b. I do not have an attorney or guardian ad litem who is helping me complete this request for the appointment of a con…

• #3

  Sign your name Date: Type or print your name Signature Attorney Guardian ad litem ADOPT-330, Page 2 of 2 Person who helped the applicant complete the form: