en-USIn the matter of en-USPetitioner � 1. � I am pregnant out of wedlock and intend to release the expected child for adoption or to consent to the child222s adoption. 2. � The approximate date of conception was en-USDateen-US at the following location: � en-USLocation, including city, county, and state 3. � The name and address of the putative father of my expected child is * en-USName (type or print) � en-USAddress City State Zipen-US . 4. � en-USI requesten-US the court to notify the putative father about his rights to file a notice of intent to claim paternity by issuing and � serving upon him a notice of intent to release or consent. en-USI declare that this petition has been examined by me and that its contents are true to the best of my information, knowledge, en-USand belief. � en-USDate en-USAttorney signature � en-USSignature of petitioner � en-USAttorney name (type or print) Bar no. � en-USName (type or print) en-USAddress � en-USAddress en-USCity, state, zip Telephone no. � en-USCity, state, zip Telephone no.en-US*The petition may include more than one putative father where circumstances warrant it. American LegalNet, Inc. www.FormsWorkFlow.com