Emancipation Petition Page 3

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THEREFORE, I request that the court, after notice to interested persons and hearing, make findings with
respect to this petition, and make an order for my emancipation from my parents.
_____________________________
Signed: ___________________________________
Date
Minor Petitioner
At _________________________ this _____________ day of ____________________. 20 ____,
personally appeared ___________________________ and did make oath that the information contained
in the foregoing petition is true and accurate, according to his/her best knowledge, information and belief.
Before me: _____________________________________________
Notary Public/Judge/Register

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