Consent To Adoption Form - Custodial Parent printable pdf download

Consent To Adoption Form - Custodial Parent

District Court

Denver Juvenile Court

__________________________________County, Colorado

Court Address:

IN THE MATTER OF THE PETITION OF:

______________________________ (

name of person(s) seeking to adopt)

COURT USE ONLY

FOR THE ADOPTION OF A CHILD

Attorney or Party Without Attorney (Name and Address):

Case Number:

Phone Number:

E-mail:

FAX Number:

Atty. Reg. #:

Division

Courtroom

CONSENT TO ADOPTION – CUSTODIAL PARENT

1. I certify that I am the birth

father

mother of ________________________________ (name of

child) and I certify that the Respondent is the birth

father

mother of said child.

2. I certify that I am consenting to the adoption of the child by the above-named Petitioner(s).

I, __________________________________, swear/affirm under oath that I have read the foregoing

Consent to Adoption - Custodial Parent and that the statements set forth herein are true to the best of

my knowledge and belief.

___________________________________

Father

Mother

Signature of

Subscribed and affirmed, or sworn to before me in the County of ________________________, State of

____________________, this _______, day of ________________, 20 _____.

My Commission Expires: ___________________

______________________________________

Notary Public/Deputy Clerk

JDF 509 R7/06

CONSENT TO ADOPTION – CUSTODIAL PARENT

Consent To Adoption Form - Custodial Parent