JDF 490 11/10 NOTICE TO TERMIMATE PARENT-CHILD LEGAL RELATIONSHIP PURSUANT TO 24719-5-105(5), C.R.S. District Court Denver Juvenile Court County, Colorado Court Address: In the Matter of the Petition of: And Petitioner For the Relinquishment of a Child, (child222s name) COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom NOTICE TO TERMINATE PARENT - CHILD LEGAL RELATIONSHIP PURSUANT TO 247 19 - 5 - 105(5), C.R.S. To Respondent(s): You are hereby notified that a Petition for Relinquishment and a Petition to Terminate Parent-Child Legal Relationship has been filed and if you wish to respond to the Petition, you must file your Response with the clerk of this Court within 30 days after this Notice is served on you. Your failure to file a Response, or to appear, within 30 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 30 days after service, if a claim has not previously been filed, may likely result in termination of your parental or your alleged parental rights to the minor child. Date: Clerk of Court/Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com