JDF 508 1 /1 8 CONSENT TO ADOPTION SOLE LEGAL PARENT District Court Denver Juvenile Court County, Colorado Court Address: I n the Matter of the Petition of : (name of person seeking to adopt ) F or the Adoption of a Child COURT USE ONLY Attorne y or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom CONSENT TO ADOPTION SOLE LEGAL PARENT PURSUANT TO 247 19 - 5 - 203(1)(d.5)(I), C.R.S. 1. I certify that I am the sole legal parent of ( name of child) . 2. I have received a copy of the Petition for Second Parent Adoption and Notice of Hearing. 3. I certify that I am voluntarily consenti ng to the adoption of the child by the above - named Petitioner. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the day of , , at (date) (month) (year) (city or other location, and state OR country (printed name of Petitioner) Signat ure American LegalNet, Inc. www.FormsWorkFlow.com