Confirmation Of Foster Care Dependency - Colorado District Court / Denver Juvenile Court
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District Court
Denver Juvenile Court
___________________ County, Colorado
Court Address:
s COURT USE ONLY s
The People of the State of Colorado in the Interest of
Case Number:
Children:
Division:
Petitioner:
CONFIRMATION OF FOSTER CARE DEPENDENCY
This is to confirm that the individual named below is/was in foster care.
NAME: _________________________________________________________ DOB: ______________________
Date entered out of home placement (foster care*): _________________________ (date of OHPO)
Continues to be in foster care
Date out of home placement (foster care*) status terminated ___________________ (date of OHPV)
Done and signed this _______________ day of _______________________________________.
BY THE COURT:
(Seal)
Clerk of Court:
________________________________
Deputy Clerk
This may be used to determine that the individual named above meets requirements for independent status on the Free Application for
th
Federal Student Aid and was in foster care at any time after their 13
birthday.
*Out of care and control of parent or parents after the age of 13, may include placement with another family member.
NOTE: If you are submitting your request by mail, you must sign this form in front of a Notary Public. If you are submitting your
request in person, you do not need to sign this form in front of a Notary Public.
_________________________________________________
_________________
Signature of Requestor
Date
The foregoing Request for Access to Adoption Records was acknowledged before me in the County of
__________________________, State of ____________________________, this ________ day of ____________, 20_____,
My Commission Expires: _________________________
__________________________________________
Notary Public
CONFIRMATION OF FOSTER CARE DEPENDENCY Rev 04/2015
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