Fill and Sign the Mn Fathers Adoption Registry Form

State of Minnesota District Court County Judicial District: Court File Number: Case Type Family Court In the Matter of: Petitioner NOTICE TO REGISTERED vs. PUTATIVE FATHER AND NOTICE OF JURISDICTION Respondent You, , have registered with the Father’s Adoption Registry indicating that you are the father of a child born on the day of , _______or expected to be born on or about the ______ day of , . The mother of the child is . The mother has indicated that she intends to place the child for adoption. As the alleged father of the child, you have certain legal rights, including the right to notice of adoption. An Adoption petition has been or will be filed in County. If you wish to retain your rights, you must file the "Intent to Claim Parental Rights" form with the following court administrator: Court Administrator _____________________________________________________________________ (Address) If you claim to be the father of the child, you must bring a paternity action within 30 days. Fill out the "Intent to Claim Parental Rights." If you do not file an "Intent to Claim Parental Rights" form , whatever legal rights you have with respect to the child may be terminated. You will not be entitled to notice of adoption proceedings. If you are not the father of the child, you should file the "Denial of Paternity" form with the court administrator. If you are the father but you consent to adoption of the child, you should file the "Consent to Adoption" form with the court administrator and you will receive no further notice of adoption. Signature: Date Mailed Print Name: For: Street Address: City/State/Zip: ADO103 State ENG Rev 9/99 www.courts.state.mn.us/forms Page 1 of 1