Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Birth Parents Affidavit And Petition To Appoint Confidential Intermediary (Parent) Form. This is a Wyoming form and can be use in Park Local County.
Loading PDF...
Tags: Birth Parents Affidavit And Petition To Appoint Confidential Intermediary (Parent), WYOAI-2, Wyoming Local County, Park
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
STATE OF WYOMING
COUNTY OF PARK
)
)
-against- )
Index No.
Calendar No.
IN THE DISTRICT COURT
:
WYOAI-2
JUDICIAL SUBPOENA
SS Plaintiff(s) JUDICIAL DISTRICT
FIFTH (5)
(12/31/91)
:
:
)
) CASE # ___________________________
OF
)
:
)
BRITH PARENT’S AFFIDAVIT AND PETITION TO
) Defendant(s) CONFIDENTIAL INTERMEDIARY,
APPOINT A
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PURSUANT . . . W.S. 1-22-203 (b)
. . . . . . . . . TO . . .
)
)
______________________________ )
IN THE MTTER OF THE ADOPTION
THE PEOPLE OF THE STATE OF NEW YORKbeing first duly sworn, on oath, petition and
________________________________ ,
TO
says:
My current address is: _____________________________________________
My current telephone number is: home _________________________________
work _________________________________
GREETINGS:
My birth son/daughter was born on _________________________ is 19 years of
age WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
or older.
,
the Honorable
at the
Court
Date of relinquishment: _________________________
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
County of relinquishment: _______________________ State: ________________
My name at the time of relinquishment: ___________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
The adoption was finalized in issued for a maximum (County) $50 and all damages
the party on whose behalf this subpoena was___________________penalty of ______ Unknown sustained as a
result of your failure to comply.
The name of my birth son/daughter at the time of birth: _______________________
Witness, Honorable
, one of the Justices of the
Adoptive parents’ name, if known: _______________________________________
Court in
County,
day of
, 20
I know the following about my birth son/daughter: ___________________________
(Attorney must sign above and type name below)
_________________________________________________________________
________________________________________________________________
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
:
I, therefore, petition this court and respectfully request that an order be entered SUBPOENA
JUDICIAL
Plaintiff(s)
appointing a confidential intermediary, pursuant to W.S. 1-22-203 (b) and that the
-againstconfidential intermediary be allowed to inspect and copy, at: the petitioner's expense, the
pertinent adoption files of the court, government agencies, and hospitals.
:
DATED this ______ day of _______________________________, 20 _______.
:
Defendant(s)
:
......................................................
_________________________________
Petitioner's Signatures
THE PEOPLE OF THE STATE OF NEW YORK
SUBSCRIBED AND SWORN to before me this ______ day of ______________
20_____.
TO
My commission expires:
GREETINGS:
___________________________
__________________________
NOTARY PUBLIC OR
WE COMMAND YOU, that all business and excuses being laid aside, you andOF COURT attend before
DEPUTY CLERK each of you
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
