District Court Denver Juvenile Court _________________________________________ County, Colorado Court Address: In the Interest of: Petitioner: v. Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg. #: Courtroom PETITION TO DISCLAIM PATERNITY I, _________________________ Petitioner, ask this Court to find that ________________________ (Name of Party) is not the biological father of the children and states: 1. Information about the Petitioner Father Mother: Check if in Military Date of Birth: ______________________ Length of Residence in Colorado: ___________________________ Current Mailing Address: ___________________________________________________________________ City & Zip: _______________________________________________________________________________ Home Phone #: ____________________ Work Phone #: ___________________ Cell #: _________________ 2. Information about the Respondent Father Mother: Check if in Military Date of Birth: ______________________ Length of Residence in Colorado: ___________________________ Current Mailing Address: ___________________________________________________________________ City & Zip: _______________________________________________________________________________ Home Phone #: ____________________ Work Phone #: ___________________ Cell #: _________________ 3. Information about the Children: Full Name of Child Present Address Sex Date of Birth 4. The Court has jurisdiction over the Respondent. 5. The minor children live in this County. 6. Each party has a continuing duty to inform the Court of any proceeding in this or any other state that could affect the current proceeding. JDF 1514 R1/06 PETITION TO DISCLAIM PATERNITY Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com 7. Identify below the name and address of each person that the children have lived with over the past five years. Please identify the relationship to the children. Name Address (City/Sate/Zip Code) Time Period (Month/Year) Type of Relationship to Children 8. I seek the following: Determination that _____________________ (name of party) is not the biological father of the children. Amendment of or issuance of new Birth Certificate(s) to show that the ____________________ (name of party) is not the biological father. Determination of costs, if appropriate. Other: ______________________________________________________________________________ ____________________________________________________________________________________ VERIFICATION AND ACKNOWLEDGEMENT I, ____________________________, declare under oath that __________________________ (name of party) is not the biological father of the minor children of this action to the best of my knowledge; and that the statements contained in this PETITION TO DISCLAIM PATERNITY are true to the best of my knowledge and belief. Date: ________________________________ __________________________________________ Signature of Petitioner Subscribed and affirmed, or sworn to before me in the County of ______________________, State of ________________, this ___________ day of _______________, 20 ______. My Commission Expires: ____________________ ___________________________________ Notary Public/Deputy Clerk JDF 1514 R1/06 PETITION TO DISCLAIM PATERNITY Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com