JC-1630, 05/19 Petition for Termination of Parental Rights 24724748.41(1), 48.415, and 48.42, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF a person under the age of 18 Date of Birth Amended Petition for Termination of Parental Rights Case No. I state on information and belief that the following is true: (If unknown or cannot be ascertained, so state) 1. Name(s) of Foster Parent or Other Physical Custodian Female Male Child has previously been adopted? Yes No County where child is present at time of filing P etition Parent #1 s Address Birthdate Name Address Birthdate 2. The petitioner is interested as . 3. The child is a marital non - marital child. 4. The above - named father is adjudicated presumed alleged biological (nonadjudicated) unknown. 5. The petitioner seeks termin ation of parental rights of Parent #1 who will may will not consent to the termination of his/her parental rights under 24748.41, Wis. Stats. If involuntary, grounds for termination of parental rights exist under 24748.415 ( ), Wis. Stats. A statement of the facts and circumstances which support these grounds is as follows: See attached Parent #2 w ho will may will not consent to th e termination of his/her parental rights under 24748.41, Wis. Stats. If involuntary, grounds for termination of parental rights exist under 24748.415 ( ), Wis. Stats. A statement of th e facts and circumstances which support these grounds is as follows: See attached 6. Names and addresses of additional possible fathers, if known, are attached. The statutory grounds for termination of the parental rights of each possible father (known or unknown) and the fa cts and circumstances which support these grounds are attached. American LegalNet, Inc. www.FormsWorkFlow.com JC-1630, 05/19 Petition for Termination of Parental Rights 24724748.41(1), 48.415, and 48.42, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 7. A . The child is not subject to the f ederal Indian Child Welfare Act. OR B . It is unknown at this time whether the child is subject to the federal Indian Child Welfare Act. ( For an Indian Child, use the Indian Child Welfare Act version (IW - 1630) form . ) 8. The Uniform Child Custody Jurisdiction Act Affidavit is attached to this P etition. 9. The best interests of the child will be served by termination of the parental rights of the parent(s). 10. The best interests of the minor birth parent(s) will be served by the termination of his her their parental rights. Petitioner Name Printed or Typed Date Petitioner Name Printed or Typed Date Name of Attorney Address Telephone Number Bar Number American LegalNet, Inc. www.FormsWorkFlow.com