Form Jd-Jm-90 - Petition For Emancipation - Connecticut Superior Court For Juvenile Matters
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3PETITION FOR EMANCIPATION
STATE OF CONNECTICUT
JD-JM-90 Rev. 7-11
SUPERIOR COURT
C.G.S. Secs. 46b-150, 150b;
JUVENILE MATTERS
PA 11-51, Sec. 19
To: The Superior Court for Juvenile Matters
Address of court
Telephone number
Docket number
Name of minor child
Sex
Age
Date of birth
Address of child
Names Of Parents Or Legal Guardians
Name
Relationship
Residence
Petitioner
Respondent
Minor
Father
Mother
Guardian
Minor
Father
Mother
Guardian
The Petitioner requests that the court declare that the minor named above is emancipated on the following statutory
grounds:
(1) The minor is in a valid marriage, whether or not that marriage has been terminated by dissolution.
(2) The minor is on active duty with any of the armed forces of the United States of America.
(3) The minor willingly lives separate and apart from parents or guardian, with or without the consent of the parents or
guardian, and the minor is managing his or her own financial affairs, regardless of the source of any lawful income.
(4) For good cause shown, it is in the best interests of the minor, any child of the minor, or the parents or guardian of the
minor.
State facts and reasons for emancipation (Use additional sheet, if necessary)
On(Date)
Signed (Petitioner)
Subscribed and
Signed (Judge, Assistant Clerk, Notary, Comm. Sup. Court)
sworn to before me:
The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA).
If you need a reasonable accommodation under the ADA, contact the Court clerk at the number listed
above or an ADA contact person listed at
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