JDF 506 R 5/19 NOTICE OF ADOPTION PROCEEDING AND SUMMONS PURSUANT TO 247 19 - 5 - 105(5), C.R.S. District Court Denver Juvenile Court County, Colorado Court Address: THE PEOPLE OF THE STATE OF COLORADO In the Interest of: , Child Date of Birth UPON THE PETITION OF: Petitioner(s) AND CONCERNING: Respondent(s) COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom NOTICE OF ADOPTION PROCEEDING AND SUMMONS TO RESPOND PURSUANT TO 247 19 - 5 - 105(5), C.R.S. T o the above named Respondent(s): You are hereby notified that a Petition for Adoption has been file d and if you wish to respond to the Petition, you must file your Response with the clerk of this Court within 3 5 days after this Notice is served on you. Your response must be accompanied by the applicable filing fee of $ 192 .00 . Your failure to file a Response , or to appear, within 3 5 days after service, and, in the case of an alleged father, your failure to file a claim of paternity under Article 4 of Title 19, C.R.S., within 3 5 days after service, if a claim has not previously been filed, may likely result in termination of your pare ntal or your alleged parental rights to the minor child. The following documents are also served herewith: (check as appropriate) Petition for (Stepparent, Kinship, Custodial ) Adoption Petition to Terminate the Parent - Child Legal Relationship (JDF 520). Affidavit of Abandonment (JDF 525) Other: Date: Clerk of Court/Deputy Clerk (This form is not to be used where service by publication is desired.) American LegalNet, Inc. www.FormsWorkFlow.com