Fill and Sign the Relinquishment Form

 District Court  Denver Juvenile Court __________________________________________County, Colorado Court Address: IN THE MATTER OF THE PETITION OF: ______________________________________________________ And _______________________________________________Petitioner(s) FOR THE RELINQUISHMENT OF A CHILD, ___________________________________________________________ (child’s name) COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom NOTICE OF EXPEDITED RELINQUISHMENT You are hereby served with a copy of the attached Petition for Relinquishment as the presumed or alleged parent of the named child. Your failure to file an answer or to appear within 20 days after service of the Petition upon you, at the Court address shown above, and, in the case of an alleged father, failure to file a claim of paternity within 20 days, may likely result in termination of parental rights concerning the child. You may waive your right to appear and contest the Petition. Failure to appear and contest may likely result in termination of the parental rights. Dated: ________________________________ ____________________________________ Petitioner AFFIDAVIT OF SERVICE I declare under oath that I am over the age of 18 years and not a party to this case and that I served this Notice of Expected Relinquishment and Petition for Expedited Relinquishment in ________________ (County) ________________ (State) on _____________ (date) at the following location: ______________________________________________________________ Check one:  By handing it to a person identified to me as the Respondent or by leaving it with the Respondent who refused service .  By leaving it with ___________________________________ designated to receive service for the Respondent.  I attempted to serve the Respondent _______ occasions but have not been able to locate the Respondent.  Private process server  Sheriff, _________________________County Fee $ ____________ Mileage $ ________ _______________________________________ S ignature of Process Server _______________________________________ Name (Print or type) My commission expires: ________________________ ___________________________________________ Notary Public /Deputy Clerk JDF 486 7/03 NOTICE OF EXPEDITED RELINQUISHMENT