中文：

领养申请书

罗伯特·摩根

律师

福勒尔顿，加州92634

电话：（714）881-2440

申请人律师

奥兰根县加利福尼亚州高级法院

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爱德华·罗德瑞格韦兹

与 序号AD-12583

尤妮斯·罗德瑞格韦兹 领养申请书（独立）

（养父母）

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申请人提出：

1、 此未成年人，也即本申请书中的主体的姓名，在出生时登记为爱丽沙贝丝·蒙德兹。

2、申请人为夫妻关系，住在加利福尼亚州奥兰根县。他们希望收养上面提到的未成年人爱丽沙贝丝·蒙德兹。该未成年人于19——年5月5日生于加利福尼亚州洛杉矶县。申请领养人为成年人，并长所述未成年人10岁。

3、该未成年人的享有单独监护资格的父母已将该未成年人交予领养申请人以备领养，他们准备同意领养申请人的领养请求。

4、该孩童为领养的适合主体。领养人有能力适当照顾并养活该未成年人，领养人的家对该未成年人来说也是适合的。领养人承诺在各个方面都会像照顾自己的合法子女一样照顾该领养孩子。

5、各领养人特此同意另一方对该孩童的收养行为。

6、领养人会尽快向奥兰根县，领养部门递交其为对领养作出调查而要求的全部信息资料。

故此，领养人请求法院裁决领养人对该孩童的领养成立，并宣布从今往后领养人和被领养人之间便形成并维持一种法律上的父母、子女关系。由此，也享有父母、子女间相互享有的权利，同时负有父母、子女关系所应担负的义务。最后，该孩子的名字应为：爱丽沙贝丝·罗德瑞格韦兹。

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爱德华·罗德瑞格韦兹，申请人

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尤妮斯·罗德瑞格韦兹，申请人

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罗伯特·摩根

申请人律师

英文：

A PETITION FOR ADOPTION

ROBERT MORGAN

Attorney at Law

320 Main Street

Fullerton, CA 92634

（714）881-2440

Attorney for petitioners

SUPERIOR COURT OF THE STSTE OF CALIFORNIA

FOR THE COUNTY OF ORANGE

In the Matter of the Adoption Petition of：

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EDWARD RODRIGUDZ

And No.AD-12583

EUNICE RODRIGUEZ PETITION FOR ADOPTION

Adopting Parents （Independent）

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Petitioners allege：

1.The mane by which the minor who is the subject of this petition was registered at birth is ELIZABETH MENDEZ.

2.The petitioners are husband and wife and reside in the County of Orange, State of California, and desire to adopt ELIZABETH MENDEZ, the above-named minor child who was born in Los Angeles County, California, on May 5, 19——. The petitioners are adult persons and more than ten years older than said minor.

3.The parents entitled to sole custody of the child have placed the child directly with the petitioners for adoption and are prepared to consent to the child's adoption by petitioners.

4.The child is a proper subject for adoption. The petitioners' home is suitable for the child, and they are able to support and care properly for the child. The petitioners agree to treat the child in all respects as their own lawful child.

5.Each petitioner hereby consents to the adoption of the child by the other.

6.The petitioners will file promptly with the Orange County Department pf Adoptions the information required by the Department in the investigation of the adoption.

WHEREFORE, petitioners pray that the Court adjudge the adoption of the child by petitioners, declaring that each petitioner and the child thenceforth shall sustain toward each other the legal relation of parent and child, and have all the rights and be subject to all the duties of that relation； and that the child shall be known sa ELIZABETH RODRIGUEZ.

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EDWARD RODRIGUDZ, Petitioner

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EUNICE RODRIGUEZ, Petitioner

ROBERT MORGAN

BY： ——

ROBERT MORGAN

Attorney for Petitioners