Fill and Sign the Consent Custodial Parent Colorado Form

 District Court  Denver Juvenile Court __________________________________County, Colorado Court 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 – 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).  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 Father/Mother Signature of F ather/Mother JDF 509 R1/18 CONSENT TO ADOPTION – CUSTODIAL PARENT