NAME AND ADDRESS OF PARTY: Telephone No:



|PARTY WITHOUT ATTORNEY or ATTORNEY |FOR COURT USE ONLY |

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|NAME: | |

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|STREET ADDRESS: | |

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|CITY: STATE: ZIP | |

|CODE: | |

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|TELEPHONE NO.: FAX NO. (Optional): | |

|E-MAIL ADDRESS (Optional): | |

|ATTORNEY FOR (Name): | |

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|SUPERIOR COURT OF CALIFORNIA, COUNTY OF MENDOCINO | |

|STREET ADDRESS: | |

|MAILING ADDRESS: | |

|CITY AND ZIP CODE: | |

|BRANCH NAME: | |

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|IN THE MATTER OF THE PETITION OF: | |

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|, Petitioner | |

| |CASE NUMBER: |

|CITATION TO APPEAR ON REQUEST FOR FREEDOM FROM PARENTAL CUSTODY AND CONTROL | |

TO: ________________________________________________ (name of absent parent):

By order of this court, you are hereby cited to appear before the court on ______________________ at _______________ in Department ____ of this court at

( 100 N. State Street, Ukiah, CA 95482 or ( 700 S. Franklin St., Fort Bragg, CA (Ten Mile Branch), to show cause why _______________________________________________________ (child’s name) should not be declared free from your parental control according to the petition filed with this Citation for the purpose of freeing said child for adoption.

The following information concerns rights and procedures that relate to this proceeding for the termination of parental control of said minor as set forth in Family Code section 7860 et seq.:

1. At the beginning of the proceeding the court will consider whether or not the interests of the minor child require the appointment of counsel. If the court finds that the interest of the minor do require the appointment of counsel, the court will appoint counsel to represent them, whether or not they are able to afford counsel. The minor will not be present in court unless they so requests or the court so orders.

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|CASE NAME: |CASE NUMBER: |

2. If a parent of the minor child appears without counsel and is unable to afford counsel, the court must appoint counsel for the parent, unless the parent knowingly and intelligently waives the right to be represented by counsel. The court will not appoint the same counsel to represent both the minor and their parent.

3. The court may appoint either the public defender or private counsel. If private counsel is appointed, he or she will receive a reasonable sum for compensation and expenses, the amount of which will be determined by the court. That amount must be paid by the real parties in interest, but not by the minor, in such proportions as the court believes to be just. If, however, the court finds that any of the real parties in interest cannot afford counsel, the amount will be paid by the county.

4. The court may continue the proceeding for not more than 30 days as necessary to appoint counsel and to enable counsel to become acquainted with the case.

Dated:__________________ _____________________________________, Clerk

By:______________________________________

Deputy Clerk

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