JDF 483 R 3 /1 8 CONSENT FOR EXPEDITED RELINQUISHMENT District Court Denver Juvenile Court County, Colorado Court Address: I n the Matter of the Petition of : And Petitioner F or the R elinquishment of Child , COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom CONSEN T FOR EXPEDITED RELINQUISHMENT PURSUANT TO 247 19 - 5 - 103.5, C.R.S. I certify that I am the alleged father presumed father of (child) and I certify that I consent to the relinquishment of said child by the above - named Petitioner . I understand that by consenting my parental rights to the child may likely be ter minated. I further understand that a hearing is set in this matter on (date). I waive the right to file an Answer and waive the right to attend any hearing in this matter and request the Court to enter an Order relinquishing my parental rights. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. SIGNATURE Printed name of Petitioner Signature of Petitioner Date American LegalNet, Inc. www.FormsWorkFlow.com