Fill and Sign the Terminate Parent Form

 District Court  Denver Juvenile Court ___________________County, Colorado Court Address: In the Matter of the Petition of: _____________________________ (name of person 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 PETITION TO TERMINATE THE PARENT-CHILD LEGAL RELATIONSHIP PURSUANT TO §§ 19-5-101, et seq. C.R.S. Comes now ___________________________________________________________, the agency/the person(s), having custody of the child, and hereby petitions the Court for an Order terminating the parent-child legal relationship, if any, which exists between the Respondent(s) ___________________________________________________ and the child named in this action and as grounds therefore, states the following: 1. That ____________________________________ (name of child) was born on _____________________ (date). 2. The mother of the child  was  was not married at the time of conception of the child or at any time thereafter to ______________________________________________________________________________. 3. The mother of the child  was  was not cohabiting with a man or men, to-wit: ___________________________________________________ at the time of the conception or birth of the child. 4. The mother of the child  has  has not received support payments or promises of support with respect to the child or in connection with her pregnancy from _________________________________________________. 5. That __________________________________________________ has formally or informally acknowledged or declared his possible paternity of the child. 6. That _______________________________________________ is named as father on the child's birth certificate. 7. That ______________________________________________ has been named as a possible father of the child. 8. That ______________________________________________ is presumed to be the father of the child, pursuant to §19-4-105, C.R.S., as amended. 9. Termination of the parent-child legal relationship, if any, between the Respondent(s) and the child is in the best interests of the chil d. JDF 520 R5-18 PETITION TO TERMINATE THE PARENT-CHILD LEGAL RELATIONSHIP Page 1 of 2 Wherefore, the Petitioner(s) respectfully request(s) that the Court upon proper notice and opportunity for hearing, enter an Order Terminating the Parent-Child legal Relationship between the Respondent(s) named above and the child and transfer guardianship of the person and legal custody of the child to a proper person or agency.  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 AND ACKNOWLEDGEMENT 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 Petitioner) (printed name of Co-Petitioner) ___________________________________ ______________________________________ Petitioner Signature Date Co-Petitioner Signature Date JDF 520 R5-18 PETITION TO TERMINATE THE PARENT-CHILD LEGAL RELATIONSHIP Page 2 of 2