H105 091 rev 4 04 2026

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  1. Click ‘Get Form’ to open the h105 091 rev 4 04 in the editor.
  2. Begin by filling out Part I, which identifies the original birth record. Enter the child's name before adoption, followed by the names of the biological parents.
  3. In Part II, provide details about the place of birth including city, county, and state. Then, fill in the child's full name and date of birth.
  4. Next, complete information regarding adoptive parents. Include their full names, social security numbers, and ages at the time of birth.
  5. Indicate if this is a single-parent adoption and provide the mailing address for adoptive parents as of the time of adoption.
  6. In Part III, enter details about the attorney handling the adoption including their name and contact information.
  7. Finally, certify that all information is accurate by signing in Part IV and providing any necessary dates or case numbers.

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You may be able to obtain a copy of the original birth certificate by filing a petition under California Health and Safety Code Section 102705 in the clerks office of the county superior court where you reside (if you live in California), or the county where the adoption was finalized.
While an adoption certificate can be used as a birth certificate, they are not exactly the same. The main difference is that an adoption certificate is issued after an individual has been adopted. This is because, often, the adoptive parents names will replace the birth parents names, especially in closed adoptions.
The adoption decree, sometimes called adoption certificate, is the document issued by the court upon finalization of an adoption, stating that the adoptee is the legal child of the adoptive parents.

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