District Court Denver Juvenile Court __________________________________ County, Colorado Court Address: IN THE MATTER OF THE PETITION OF: ______________________________________________ (Persons(s) seeking to adopt) FOR THE ADOPTION OF AN ADULT ______________________________________________ (Adoptee's Name) COURT USE ONLY Case Number: Division Courtroom NOTICE AND SUMMONS FOR ADULT ADOPTION You are hereby summoned and required to file with the Clerk of this Court, an Answer/Consent form to the attached Petition for Adult Adoption. Your failure to file the Answer and Consent for Adult Adoption, within 21 days after service, shall dismiss this adult adoption action. The following documents are served herewith: Petition for Adult Adoption (JDF 528) Consent/Answer for Adult Adoption (JDF 529) Dated: ________________________________ CLERK OF THE COURT By: __________________________________ Deputy Clerk AFFIDAVIT OF SERVICE I declare under oath that I am over the age of 18 years and not a party to this case and that I served this Notice and Summons for Adult Adoption, Petition for Adult Adoption and Consent/Answer for Adult Adoption in __________________ (County) ___________________________ (State) on _____________________ (date) at the following location: ____________________________________________________________________________________________________ Check one: By handing it to a person identified to me as the Respondent or by leaving it with the Respondent whom refused service. By leaving it with ___________________________________ designated to receive service for the Respondent. I attempted to serve the Respondent _______ occasions but have not been able to locate the Respondent. Private process server Sheriff, _________________________County Fee $ ____________ Mileage $ ________ _______________________________________ Signature of Process Server _______________________________________ Name (Print or type) My Commission Expires: ________________________ ___________________________________________ Notary Public /Deputy Clerk Date JDF 530 R1-12 NOTICE AND SUMMONS FOR ADULT ADOPTION American LegalNet, Inc. www.FormsWorkFlow.com