Declaration Of Minor Who Has Filed Pseudonymous Petition To Waive Parental Notification
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Declaration Of Minor Who Has Filed Pseudonymous Petition To Waive Parental Notification Form. This is a Iowa form and can be use in District Court Statewide.
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Tags: Declaration Of Minor Who Has Filed Pseudonymous Petition To Waive Parental Notification, Rule 8.34 Form 2, Iowa Statewide, District Court
Rule 8.34 — Form 2
February 2002
IN THE IOWA DISTRICT COURT FOR ________________________ COUNTY
(JUVENILE DIVISION)
IN THE INTEREST OF
_____________________________________,
A Minor.
Juvenile No. _______________________
DECLARATION OF MINOR WHO
HAS FILED PSEUDONYMOUS PETITION
TO WAIVE PARENTAL NOTIFICATION
UNDER IOWA CODE CHAPTER 135L
NOTICE TO THE CLERK OF COURT: A CERTIFIED COPY OF THIS DECLARATION, WITH THE FILE NUMBER NOTED ON IT, SHOULD BE GIVEN TO THE MINOR AFTER SHE SIGNS IT.
THE ORIGINAL SHOULD IMMEDIATELY BE PLACED IN A SEALED ENVELOPE, WHICH SHOULD BE
FILED UNDER SEAL AND KEPT UNDER SEAL AT ALL TIMES.
1.
My true name is ____________________________________________________________, and my address is
(print your name)
_____________________________________________________________________________________________.
(print your address)
2. My date of birth is _________________________.
3.
I have filed a petition to waive parental notification, under the name ___________________________________
____________________________________ on ______________________________________________________.
(date)
I declare, under penalty of perjury, that the foregoing is true and correct.
Dated: ___________________ Signed: _____________________________________________________________
(You must sign your true name)
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