IN THE CIRCUIT COURT IN THE EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR BREVARD COUNTY, FLORIDA. Case No.: IN RE: TERMINATION OF PARENTAL RIGHTS PENDING STEPPARENT ADOPTION OF Bar Code Label ___________________________________/ Minor Child(ren) NOTICE OF PETITION TO TERMINATE PARENTAL RIGHTS PENDING STEPPARENT ADOTION AND NOTICE OF HEARING A Petition to Terminate Parental Rights Pending Adoption by Stepparent has been filed. A copy of the petition is being served with this notice. There will be a hearing on the Petition to Terminate Parental Rights Pending Adoption by Stepparent before Judge {name} __________________________, on {date} _______________________, 200___, at {time} _________m., in Room ___________ of the _____________________________________________________ Courthouse. The court has reserved ______hour(s)/ _______ minutes for this hearing. If you executed a Consent to Adoption or an Affidavit of Nonpaternity and a Waiver of Venue, you have the right to request that the hearing on the Petition to Terminate Parental Rights be transferred to the county in which you reside. You may object by appearing at the hearing or filing a written objection with the Court. UNDER SECTION 63.089, FLORIDA STATUTES, FAILURE TO FILE A WRITTEN RESPONSE TO THIS NOTICE WITH THE COURT OR TO APPEAR AT THIS HEARING CONSTITUTES GROUNDS UPON WHICH THE COURT SHALL END AN ANY PARENTAL RIGHTS YOU MAY HAVE REGARDING THE MINOR CHILD. This part to be filled out by the Court or to be filled in with information you obtained from the Court: __________________________________________ Signature of Party Law 1044 – Rev. 10/2005 American LegalNet, Inc. www.FormsWorkflow.com NOTICE OF PETITION TO TERMINATE PARENTAL Case No:_________________________________ RIGHTS PENDING STEPPARENT ADOTION AND NOTICE OF HEARING Page 2 Printed Name:________________________ Address:_____________________________ City, State, Zip:_______________________ Telephone #:_________________________ Fax #:______________________________ IF A NONLAWYER HELPD YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [- fill in all blanks] I, {full legal name and trade name of nonlawyer} ___________________________________________, a nonlawyer, located at {street} ___________________________, {city} _______________________, {state} ___________, {phone} ______________, helped {name} _____________________________, whose is the _____________________________, fill out this form. If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no costs to you, to the provision of certain assistance. Please contact Court Administration at the Moore Justice Center, 2825 Judge Fran Jamieson Way, 3rd Floor, Viera, Florida 32940-8006, telephone (321) 633-2171, ext. 2, within 2 working days of your receipt of this Notice of Hearing. If you are hearing or voice impaired, call TDD 1-800-955-8771. Law 1044 – Rev. 10/2005 American LegalNet, Inc. www.FormsWorkflow.com