FAMILY COURT _________ CIRCUIT STATE OF HAWAI‘I NOTICE OF TIME AND PLACE OF HEARING CASE NUMBER FC-A NO. (By Publication) In the Matter of Adoption of A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: by [ ]the legal spouse of [ ]and [ ]the child(ren)'s legal parent [ ]husband and wife [ ]an unmarried person Petitioner(s). THE STATE OF HAWAI‘I TO: Name and Address of Non-Consenting Parent/Legal Guardian/Legal Custodian YOU ARE HEREBY NOTIFIED that a petition for adoption of the above-identified child(ren) born , the child(ren)’ s mother, has been filed in the Family to Court, First Circuit, State of Hawai‘i. THE PETITION ALLEGES that your consent to the adoption of the above-named child(ren) by the Petitioner(s) above-named is not required and may be dispensed with pursuant to Hawai‘i Revised Statutes Section 578-2(c) as amended. 08/07/01 PAGE 1 OF 2 PAGES NOTICE OF TIME AND PLACE OF HEARING (By Publication) American LegalNet, Inc. www.FormsWorkflow.com FAMILY COURT _______ CIRCUIT STATE OF HAWAI‘I NOTICE OF TIME AND PLACE OF HEARING CASE NUMBER FC-A NO. (By Publication) A hearing on the Petition will be held on at .m. at the Family Court located at the Ka‘ahumanu Hale, 777 Punchbowl Street, Second Floor, Honolulu, Hawai‘i. IF YOU FAIL to appear at the hearing on date and time and at the place noted above or if you fail to file a written response to the allegations reflected in the Petition for Adoption, further action may be taken including the granting of the adoption without further notice to you. Your written response should be addressed to the Presiding Judge, Family Court, First Circuit, 777 Punchbowl Street, Second Floor, Honolulu, Hawai‘i 96813 (mailing address: P. O. Box, Honolulu, Hawai‘i 96811). FAILURE TO OBEY this notice may result in an entry of a default and default judgment against you. YOU ARE FURTHER NOTIFIED that the child, the adoptive parents and the natural parents have rights under H.R.S. Section 578-15 regarding confidentiality of adoption records after the child reaches age 18. DATE SIGNATURE OF THE CLERK THIS NOTICE SHALL NOT BE PERSONALLY DELIVERED BETWEEN 10:00 P.M. AND 6:00 A.M. ON PREMISES NOT OPEN TO THE PUBLIC, UNLESS A JUDGE OF THIS COURT PERMITS, IN WRITING ON THIS NOTICE, PERSONAL DELIVERY DURING THOSE HOURS. 08/07/01 PAGE 2 OF 2 PAGES NOTICE OF TIME AND PLACE OF HEARING (By Publication) American LegalNet, Inc. www.FormsWorkflow.com