Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC-609 REV. 7/19 CONNECTICUT PROBATE COURTS Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC - 609 Page 1 of 3 RECEIVED: Instructions: 1) Any party in a proceeding for removal of a parent as guardian, appointment of guardian, termination of parental rights or adoption, or a person who was a party in a prior proceeding, may use this form to request that the court make findings in support of a petition with the United States Citizenship and Immigration Services for designation of the minor as having special immigrant juvenile status under 8 U.S.C. section 1101(a)(27)(J). 2)The petition may be filed with a petition for: (a) removal of parent or other guardian of the minor,(b) appointment of a guardian, (c) termination of parental rights or (d) adoption. If a Probate Court previously granted a petition for removal of guardian, appointment of guardian, termination of parental rights or adoption, the petition must be filed in the court that granted the petition. 3)For further information, see C.G.S. sections 45a-608n, 45a-610 (removal of guardian) and 45a-616(appointment of guardian) or C.G.S. sections 45a-608o, 45a-717 (termination of parental rights) and 45a-727 (adoption). 4)Type or print in ink. Use an additional sheet, or PC-180, if more space is needed. Probate Court Name District Number In the Matter of (Name and address) Hereinafter referred to as the minor Minor222s Date of Birth Petitioner (Name , address and telephone number ) Petitioner (Name, address and telephone numbe r) Petitioner222s Relationship to Minor: Petitioner222s Relationship to Minor: The pe titioner represent s that: This petition is filed with or during the pendency of a petition for: Removal of parent or other guardian Termination of parental rights Appointment of guardian Adoption On , , the Probate Court granted a petition for: Removal of parent or other guardian Termination of parental rights Appointment of guardian Adoption The minor is under 21 years of age. The minor is not married. American LegalNet, Inc. www.FormsWorkFlow.com Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC-609 REV. 7/19 CONNECTICUT PROBATE COURTS In the Matter of Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC - 609 Page 2 of 3 Reunification of the minor with , the mother/ parent of the minor, is not viable due to the following grounds for removal of parent as guardian under C.G.S. section 45a-610(2) to (5) or termination of parental rights under C.G.S. section 45a - 717(g)(2) : ( Explain ) Reunification of the minor with , the father/ parent of the minor, is not viable due to the following grounds for removal of parent as guardian under C.G.S. section 45a-610(2) to (5) or termination of parental rights under C.G.S. section 45a - 717(g)(2): (Explain ) It is not in the best interests of the minor to be returned to the minor222s or pare nt222s country of nationality or last habitual residence for the following reasons: ( Explain ) American LegalNet, Inc. www.FormsWorkFlow.com Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC-609 REV. 7/19 CONNECTICUT PROBATE COURTS In the Matter of Petition/Special Immigrant Juvenile Findings nder 8 U.S.C. section 1101 PC - 609 Page 3 of 3 WHEREFORE the petitioner(s) requests that the court issue findings to be used in connection with a petition to the United States Citizenship and Immigration Services for designation of the minor as having special immigrant juvenile status under 8 U.S.C. section 1101(a)(27)(J). The representations made in this petition are made under penalty of false statement. Signature of Petitioner Type or Print Name Date Signature of Petitioner Type or Print Name Date American LegalNet, Inc. www.FormsWorkFlow.com