California Family Code § 7613.5

Family Code
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(a) An intended parent may, but is not required to, use the forms set forth in this section to demonstrate the intent to be a legal parent of a child conceived through assisted reproduction. These forms shall satisfy the writing requirement specified in Section 7613, and are designed to provide clarity regarding the intentions, at the time of conception, of intended parents using assisted reproduction. These forms do not affect any presumptions of parentage based on Section 7611, and do not preclude a court from considering any other claims to parentage under California statute or case law. (b) These forms apply only in very limited circumstances. Please read the forms carefully to see if you qualify for use of the forms. (c) These forms do not apply to assisted reproduction agreements for gestational carriers or surrogacy agreements. (d) This section does not require the use of one of these forms to satisfy the writing requirement of Section 7613. (e) The following are the optional California Statutory Forms for Assisted Reproduction: California Statutory Forms for Assisted Reproduction, Form 1: Two Married or Unmarried People Using Assisted Reproduction to Conceive a Child Use this form if: You and another intended parent, who may be your spouse or registered domestic partner, are conceiving a child through assisted reproduction using sperm and/or egg donation; and one of you will be giving birth. WARNING: Signing this form does not terminate the parentage claim of a sperm donor. A sperm donor’s claim to parentage is terminated if the sperm is provided to a licensed physician and surgeon or to a licensed sperm bank prior to insemination, or if you conceive without having sexual intercourse and you have a written agreement signed by you and the donor that you will conceive using assisted reproduction and do not intend for the donor to be a parent, as required by Section 7613(b) of the Family Code. The laws about parentage of a child are complicated. You are strongly encouraged to consult with an attorney about your rights. Even if you do not fill out this form, a spouse or domestic partner of the parent giving birth is presumed to be a legal parent of any child born during the marriage or domestic partnership. This form demonstrates your intent to be parents of the child you plan to conceive through assisted reproduction using sperm and/or egg donation. I, ____________________ (print name of person not giving birth), intend to be a parent of a child that ____________________ (print name of person giving birth) will or has conceived through assisted reproduction using sperm and/or egg donation. I consent to the use of assisted reproduction by the person who will give birth. I INTEND to be a parent of the child conceived . SIGNATURES Intended parent who will give birth: ___________________ (print name) ________________________ (signature) ____________(date) Intended parent who will not give birth: ____________ (print name) _________________________ (signature) ___________(date) NOTARY ACKNOWLEDGMENT State of California County of ) On before me, (insert name and title of the officer) personally appeared , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity, and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) California Statutory Forms for Assisted Reproduction, Form 2: Unmarried, Intended Parents Using Intended Parent’s Sperm to Conceive a Child Use this form if: (1) Neither you or the other person are married or in a registered domestic partnership (including a registered domes

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