JDF 520 R 5 - 1 8 PETITION TO TERMINATE THE PARENT - CHILD LEGAL RELATIONSHIP Page 1 of 2 District Court Denver Juvenile Court County, Colorado Court Address: In the Matter of the Petition of: (name of person seeking to adopt) For the Adoption of a Child COURT USE ONLY Atto rney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION TO TERMINATE THE PARENT - CHILD LEGAL REL ATIONSHIP PURSUANT TO 247 247 19 - 5 - 10 1 , et seq. C.R.S. C omes now , the agency/the person(s), having custody of the child, and hereby petitions the Court for an Order terminating the parent - child legal relationship, if any, which exists between the Respondent(s) and the child named in this action and as grounds therefore, states the following: 1. That (name of child) w as born on ( date) . 2. T he mother of the child was was not married at the time of conception of the child or at any time thereafter to . 3. Th e mother of the child was was not cohabiting with a man or men, to - wit: at the time of the conception or birth of the child . 4. T he mother of the child has has not received support payments or promises of support with respect to the child or in connection with her pregnancy from . 5. That has formally or informally acknowledged or declared his possible paternity of the child . 6. That is n amed as father on the child's birth certificate . 7. That has been named as a possible father of the child . 8. That is presumed to be the father of the child, pursua nt to 24719 - 4 - 105, C.R.S., as amended . 9. T ermination of the parent - child legal relationship, if any, between the Respondent(s) and the child is in the best interests of the chil d. American LegalNet, Inc. www.FormsWorkFlow.com JDF 520 R 5 - 1 8 PETITION TO TERMINATE THE PARENT - CHILD LEGAL RELATIONSHIP Page 2 of 2 W herefor e , the Petitioner(s) respectfully request(s) that the Court upon prope r notice and opportunity for hearing, enter an Order Terminating the Parent - Child legal Relationship between the Respondent(s) named above and the child and transfer guardianship of the person and legal custody of the child to a proper person or agency. 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. VERIFICATION AND ACKNOWLEDGEMENT 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) (printed name of Co - Petitioner) Petitioner Signature Date Co - Petitioner Signature Date American LegalNet, Inc. www.FormsWorkFlow.com