Fill and Sign the Jc 1637 Consent to Termination of Parental Rights Judicial Form

JC-1630 , 02/1 6 Petition for Termination of Parental Rights §§48.41(1), 48.415, and 48.42, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY For Official Use IN THE INTEREST OF a person under the age of 18. Amended Petition for Termination of Parental Rights Date of Birth Case No. I state on information and bel ief that the following is true : [if unknown or cannot be ascertained, so state] 1. Petitioner’s Name and Address Child’s Address County where child is present at time of filing petition Sex Child has previously been adopted? Yes No Parent #1 ’s Name Parent #1’ s Address Birthdate Parent #2’s Name Parent #2’s Address Birthdate Child’s Legal Guardian Legal Guardian’s Address Child’s Legal Custodian Legal Custodian’s Address 2. The petitioner is interested as . 3. The child is a marital non -marital child. 4. The father is adjudicated. presumed. alleged. biological (nonadjudicated) . unknown. Names and addresses of additional possible fathers, if known, are attached. 5. The petitioner seeks termination of parental rights of the: mother, who will may will not consent to the termi nation of her parental rights under §48.41, W is. Stats. If involuntary, grounds for termination of parental rights exist under §48.415( ), Wis. Stats. A statement of the facts and circumstances which support these grounds is as follows: See attached Petition for Termination of Parental Rights Page 2 of 2 Case No. JC-1630 , 02/16 Petition for Termination of Parental Rights §§48.41(1), 48.415, and 48.42, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 father, who will may will not consent to the termination of his parental rights under §48.41, W is. Stats. If involuntary, grounds for termination of parental rights exist under §48.415( ), Wis. Stats. A statement of the facts and circumstances which support these grounds is as follows: See attached additional possible fathers (known or unknown) . Attach name(s) if known. The statutory grounds for termination of the parental rights of each possible father and the facts and circumstances whi ch support these grounds are attached. 6. a. The child is not subject to the f ederal Indian Child Welfare Act OR b. It is unknown at this time whether the child is subject to the federal Indian Child Welfare Act. (For an Indian Child, use the Indian Child Welfare Act version (IW -1630) of this petition. ) 7. The Uniform Child Custody Jurisdiction Act Affidavit is attached to this petition. 8. The best interests of the child will be served by termination of the parental rights of the parent(s). 9. The best interests of the minor birth parent(s) will be served by the termination of his her their parental rights.  Signature of Petitioner Name Printed or Typed Date  Signature of Petitioner Name Printed or Typed Date Name of Attorney Address Telephone Number Bar Number