Fill and Sign the Affidavit Sibling Form

 District Court  Denver Juvenile Court _________________________________________ County, Colorado Court Address: IN THE MATTER OF THE ADOPTION OF : Birth Name of Adoptee (If known) A ND CONCERNING Current Legal Name of Petitioner COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY SIBLING OF AN ADOPTEE OR HALF-SIBLING OF AN ADOPTEE I, _______________________________________________________________________________, declare under oath that: My current address is: _________________________________________________________________________________. (Street Address, City, State, Zip) My date of birth is: ________________________________________ My maiden name (if applicable ) is: _____________________________ My current telephone numbers are: (Home) ________________________________ (Work) ___________________________ My birth brother/sister was born on (date): Date of relinquishment: County and State of relinquishment: Birth mother’s name at time of relinquishment: Birth father’s name at time of relinquishment: Birth mother’s maiden name: Alias * used by birth mother at time of relinquishment: * If possible, provide birth mother’s birth certificate My birth brother’s/sister’s name at time of birth was: My birth brother’s/sister’s city and state of birth was: Name of Home: Name of Hospital: Name of Agency: The adoption was finalized in County, Colorado OR  Unknown I know the following about my birth brother/sister and his/her adoptive parents: _____________________________________ I am seeking my birth brother/sister because: ________________________________________________________________ JDF 342 R1/18 MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY SIBLING OF AN ADOPTEE Page 1 of 2 OR HALF-SIBLING OF AN ADOPTEE I petition the Court to order the adoption files of the _______________________ Court for ____________________________ County, and any hospital, homes, adoption agencies, state or public agencies or courts that have files concerning this case, be open for review by a confidential intermediary.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ___________________, _________, at ___________________________________________ (date) (month) (year) (city or other location, and state OR country ___________________________________ ________________________________________________ (Printed name of Petitioner) Signature of Petitioner JDF 342 R1/18 MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY SIBLING OF AN ADOPTEE Page 2 of 2 OR HALF-SIBLING OF AN ADOPTEE