Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR For Clerk's Use Only Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the matter of: Case Number: JS A Minor WAIVER BY PARENT OF NOTICE OF HEARING AND APPEARANCE ON PETITION FOR TERMINATION OF PARENTCHILD RELATIONSHIP UNDER OATH or by AFFIRMATION: INFORMATION FROM PARENT whose rights are to be terminated 1. I, , am the MOTHER FATHER of the minor children named below for whom a Petition has been filed requesting permanent termination (severance) of my parental rights: Full Name of Child Date of Birth 2. My complete name and address and date of birth is as follows: Name: Street Address: City, State, Zip Code: Telephone: Date of Birth: (Continues on next page) �Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 2 JS19f-042916 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: JS WAIVER OF NOTICE 1. 2. I have read the Petition for Termination of Parental Rights between myself and the minor child or children. I waive notice of all further proceedings in this matter. I understand that I can reverse this waiver by filing a written document with the court under this court case number declaring that I no longer waive notice of hearings and other court proceedings. Date Signature STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) . by (notary seal) Deputy Clerk or Notary Public �Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 2 JS19f-042916 American LegalNet, Inc. www.FormsWorkFlow.com