Colorado > Statewide > Adoption
Petition For Relinquishment Expedited Relinquishment JDF 452 - Colorado
| Petition For Relinquishment Expedited Relinquishment Form. This is a Colorado form and can be used in Adoption Statewide . |
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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) Attorney or Party Without Attorney (Name and Address): Phone Number: FAX Number: E-mail: Atty. Reg. #: COURT USE ONLY Case Number: Division Courtroom PETITION FOR RELINQUISHMENT OR EXPEDITED RELINQUISHMENT PURSUANT TO §19-5-103.5, C.R.S. The Petitioner(s) respectfully represent(s) to the Court: 1. _____________________________________ (name of child), was born on _________________ (date), in _______________________________ (city/state), and is the child of the Petitioner(s). 2. The names, dates of birth, and addresses of the parents of the child are: Information about the Mother: Mother's Name: Street Address: Mailing Address, if different: City: Email Address: Information about the Father: Name: Street Address: Mailing Address, if different: City: Email Address: Information about the Father: Name: Street Address: Mailing Address, if different: City: Email Address: JDF 452 Petitioner Co-Petitioner/Respondent Date of Birth: State: Zip Code: Main Phone #: Secondary Phone #: Petitioner Co-Petitioner/Respondent Date of Birth: Presumed Alleged State: Zip Code: Main Phone #: Secondary Phone #: Petitioner Co-Petitioner/Respondent Date of Birth: Presumed Alleged State: Zip Code: Main Phone #: Secondary Phone #: Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com R03/11 PETITION FOR RELINQUISHMENT/EXPEDITED RELINQUISHMENT 3. Venue is proper in this county because: (a) The Petitioner(s) reside(s) in this county at OR (b) The child resides in this county at OR (c) A Child Placement Agency, is involved and is located in this county with an office registered with the Colorado Department of Human Services at: 4. The Petitioner(s) wish(es) to relinquish the child because: 5. The Petitioner(s) believes that this relinquishment is in the best interest of the child named above. 6. The Petitioner(s) understand(s) that: After the Order of Relinquishment is entered, the Petitioner(s) will be unable to change his/her/their mind(s) about relinquishment. OR If this is an Expedited Relinquishment, the Petitioner(s) understand(s) that after the Petition is filed with the Court that the Petitioner(s) will be unable to withdraw the attached affidavit in support of the relinquishment. 7. The Petitioner(s) understand(s) that this is a permanent termination of parental rights with respect to the child named above. 8. The Petitioner's decision to relinquish the child named above is knowing and voluntary and without undue pressure or influence from anyone else. 9. The Petitioner(s) has/have has/have not received counseling from regarding this proposed relinquishment, as described in the attached Affidavit of Relinquishment Counseling. has/have has/have not received, been promised or offered any payments, gifts, 10. The Petitioner(s) assistants, goods, or services and the source of such payments. JDF 452 R03/11 PETITION FOR RELINQUISHMENT/EXPEDITED RELINQUISHMENT Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 11. The child is is not a member or eligible to be a member of an Indian tribe as defined by the Indian Child . Welfare Act. If applicable, name of tribe (Attached is assessment form JDF 567 or JDF 568, to comply with the Indian Child Welfare Act (ICWA). Notice of this Petition has been provided to the parent or Indian custodian of the child and to the tribal agent of the tribe, as required by §19-1-126(1)(c), C.R.S. Reasonable efforts have been made to send notice to the identified persons as follows: Attach the postal receipts to this petition, indicating that notice was properly sent. If the postal receipts have not been returned at the time of filing, the postal receipts or copies shall be filed with the Court within ten days of the filing of this petition. 12. The child is is not twelve years of age or older. 13. The child is is not one year of age at the time of filing this Petition. 14. The child has has not received counseling in connection with this proposed relinquishment. Wherefore, the Petitioner(s) respectfully request(s) that the Court enter a Final Order of Relinquishment and transfer guardianship of the person and legal custody of the child to a proper person or agency. VERIFICATION AND ACKNOWLEDGEMENT I swear/affirm under oath that I have read the foregoing Petition and that the statements set forth therein are true and correct to the best of my knowledge. ___________________________________ Petitioner Signature Date Subscribed and affirmed, or sworn to before me By___________________________________ in the County of ________________________, State of ____________________, this _______ day of ________________, 20 ____. My Commission Expires: ___________________ _______________________________________ Notary Public/Clerk JDF 452 ______________________________________ Co-Petitioner Signature Date Subscribed and affirmed, or sworn to before me by ____________________________________ in the County of _________________________, State of ___________________, this ________ day of ________________, 20 ____. My Commission Expires: ___________________ ______________________________________ Notary Public/Clerk Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com R03/11 PETITION FOR RELINQUISHMENT/EXPEDITED RELINQUISHMENT
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