! District Court ! Denver Juvenile Court __________________________________________County, Colorado Court Address: IN THE MATTER OF THE PETITION OF: FOR THE ADOPTION OF A CHILD COURT USE ONLY Case Number: Attorney or Party Without Attorney (Name and Address): Phone Number: FAX Number: E-mail: Division Courtroom Atty. Reg.#: AFFIDAVIT IN SUPPORT OF PETITION FOR KINSHIP ADOPTION The Petitioner(s), ___________________________________________________________________________ and ___________________________________________________________ swear(s) and affirm(s) that: 1. He/she/they is/are the child’s ! aunt ! uncle ! sister ! brother ! half-sibling ! first cousin or ! grandparent; 2. The parent(s) of the subject child, ___________________________________________________________________ and ________________________________________________________________________, ! Has/have failed without cause to provide reasonable support for the child for a period of one (1) year or more OR ! Has/have abandoned the child for a period of one year or more. 3. The Petitioner(s) has/have had physical custody of the child for a period of one year or more. 4. The child is not the subject of a pending dependency and neglect proceeding pursuant to article 3 of title 19 of the Colorado Revised Statutes. Petitioner(s), being first duly sworn, upon oath, state(s) that he/she/they has/have read the foregoing Affidavit and know(s) the contents thereof, and the same are true. ____________________________________________ Petitioner ___________________________________________ Petitioner Subscribed and sworn to before me this __________ day of _________________________________________, __________. My commission expires: ________________________ JDF 505b 8/00 ___________________________________________ Deputy Clerk/Notary Public AFFIDAVIT IN SUPPORT OF PETITION FOR KINSHIP ADOPTION 2001 © American LegalNet, Inc.