(a) The voluntary declaration of parentage shall be executed on a form developed by the Department of Child Support Services in consultation with the State Department of Public Health and groups addressing child support, child custody, assisted reproduction issues, and lesbian, gay, bisexual, and transgender rights.(b) The form described in subdivision (a) shall contain, at a minimum, all of the following: (1) The name and the signature of the woman who gave birth to the child.(2) The name and the signature of the person seeking to establish parentage.(3) The name of the child.(4) The date of birth of the child.(5) For a voluntary declaration of parentage signed pursuant to paragraph (1) of subdivision (a) of Section 7573, all of the following:(A) A statement by the woman who gave birth that the woman is unmarried and understands the written materials described in Section 7572, that the person who is signing the voluntary declaration of parentage is the only possible genetic parent other than the woman who gave birth, that the woman who gave birth consents to the establishment of parentage by the genetic parent signing the voluntary declaration of parentage, and that the woman who gave birth understands that a challenge by a signatory to a valid declaration of parentage is permitted only under limited circumstances and is barred two years after the effective date of the declaration.(B) A statement by the person signing the voluntary declaration of parentage that the person has read and understands the written materials described in Section 7572, understands that by signing the voluntary declaration of parentage the person is waiving rights as described in the written materials, that the person is the genetic parent of the child, that the person consents to the establishment of parentage by signing the voluntary declaration of parentage, that the person is assuming all the rights and responsibilities of a parent and wishes to be named on the child's birth certificate, and that the person understands that a challenge by a signatory to a valid declaration of parentage is permitted only under limited circumstances and is barred two years after the effective date of the declaration.(6) For a voluntary declaration of parentage signed pursuant to paragraph (2) of subdivision (a) of Section 7573, all of the following:(A) A statement by the woman who gave birth that the woman has read and understands the written materials described in Section 7572, that the person who is signing the voluntary declaration of parentage is the intended parent of a child conceived through assisted reproduction, that the woman who gave birth consents to the establishment of parentage by the other person signing the voluntary declaration of parentage, and that the woman who gave birth understands that a challenge by a signatory to a valid declaration of parentage is permitted only under limited circumstances and is barred two years after the effective date of the declaration.(B) A statement that the person seeking to establish parentage has read and understands the written materials described in Section 7572, understands that by signing the voluntary declaration of parentage the person is waiving rights as described in the written materials, that the person is the intended parent of the child conceived through assisted reproduction, that the person consents to the establishment of parentage by signing the voluntary declaration of parentage, that the person is assuming all the rights and responsibilities of a parent and wishes to be named on the child's birth certificate, and that the person understands that a challenge by a signatory to a valid declaration of parentage is permitted only under limited circumstances and is barred two years after the effective date of the declaration.(7) The name and the signature of the person who witnesses the signing of the declaration.Amended by Stats 2019 ch 115 (AB 1817),s 84, eff. 1/1/2020.Added by Stats 2018 ch 876 (AB 2684),s 36, eff. 1/1/2019.