Fill and Sign the And Waive Any and All Notices Required by Law Form

JDF 511 R1/18 CONSENT TO ADOPTION – CHILD OVER 12 YEARS OF AGE  District Court  Denver Juvenile Court___________________________________County, ColoradoCourt Address:IN THE MATTER OF THE PETITION OF:_______________________________ (name of person(s) seeking to adopt)FOR THE ADOPTION OF A CHILD COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #:Case Number:Division Courtroom CONSENT TO ADOPTION – CHILD OVER 12 YEARS OF AGE 1.I hereby consent to my adoption by _____________________________________ (name of party)and waive any and all notices required by law.2. I am ____________ years of age and my date of birth is ________________________________.I, _________________________________, swear/affirm under oath that I have read the foregoing Consent to Adoption – Child Over 12 Years of Age and that the statements set forth herein are true to the best of my knowledge and belief. 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 Adoptee Signature of Adoptee