"Do you mean that I need to sign and date the form when the filing is accepted?"
Yes. But since you don't actually file this form, in practice, it's not ever necessary unless you are audited and the State asks for a copy.
"Do you mean print the file and sign it or sign it electronically?"
The instructions mean print and sign, but, again, since you are just going to stick this in your tax files, you can leave it as part of your PDF until the State of California asks for it (only in an audit).
"Do I need to send out the signed form (if yes, where should I send it?), or just keep it for record?"
You keep it in your tax records. See the instruction at the top of the form: "DO NOT MAIL THIS FORM TO THE FTB".
If you print your return to have a copy, just have this form be part of your tax records. If you just keep the PDF of the tax return, then this is one of the pages in the PDF.
Otherwise, unless the State of California in the very unlikely case asks for this form, don't worry about it.
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