Fill and Sign the Interstate Compact on the Placement of Form

JDF 341 R1-18 MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY ADOPTIVE PARENT Page 1 of 2 OR CUSTODIAL GRANDPARENT District Court  Denver Juvenile Court_________________________________________ County, ColoradoCourt Address:IN THE MATTER OF THE ADOPTION OF:Birth Name of Adoptee (If known) AND CONCERNINGCurrent Legal Name of Petitioner COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg.#:Case Number:Division Courtroom MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY ADOPTIVE PARENT OR CUSTODIAL GRANDPARENT I, _______________________________________________________________________________, declare under oath that:My current address is: __________________________________________________________________________________. (Street Address, City, State, Zip) My date of birth is: ___________________________My current telephone numbers are: (Home) ________________________________ (Work) ___________________________ The adoptive parents’ address at the time of adoption was: The adoptee was born on: __________________________ Date of adoption: ______________________________________The agency arranging the adoption was: ___________The attorney arranging the adoption was: ___________________________________________________________________The adoption was finalized in _____________________________________ County, Colorado. I know the following about the birth parents of my adopted child or grandchild: ______________________________________________________________I am seeking the birth parents of my adopted child or grandchild because: _________________________________________The current name and address of my adopted child or grandchild is: _____________________________________________ My adopted child or grandchild  is  is not at least 18 years of age. JDF 341 R1-18 MOTION AND AFFIDAVIT TO OPEN ADOPTION FILE BY ADOPTIVE PARENT Page 2 of 2 OR CUSTODIAL GRANDPARENTMy adopted child or grandchild  does  does not currently live in my home.My adopted child or grandchild  does  does not know that I am petitioning on his/her behalf.I petition the Court to order the adoption files of the _______________________ Court for ____________________________ County, and any hospital, homes, adoption agencies, state or public agencies or courts that have files concerning this case, be open for review by a confidential intermediary. 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 Petitioner) Signature of Petitioner