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Consent Release Or Refusal (Petition To Open Adoption And Relinquishment Files) Form. This is a Wyoming form and can be use in Park Local County.
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Tags: Consent Release Or Refusal (Petition To Open Adoption And Relinquishment Files), WYCAI-4, Wyoming Local County, Park
COURT
OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
............
:
STATE OF COUNTY
WYOMING
STATE OF WYOMING
COUNTY OF PARK
IN RE:
)
)
)
WYCAI-4
(12/31/91)
Index No.
:
Calendar No.
IN THE DISTRICT COURT
FIFTH (5TH) JUDICIAL DISTRICT
:
JUDICIAL SUBPOENA
Plaintiff(s)
SS
-againstPETITIONS TO OPEN ADOPTION AND
RELINQUISHMENT FILES
:
)
)
:
)
)
:
)
) CONSENT RELEASE OR REFUSAL
Defendant(s)
:
)
.............................
..... .......
_______________________________. . . . . . . . .) . . CASE .#. ____________
I HEREBY CONSENT to contact with my _______________________________________
(relationship)
THE PEOPLE OF THE STATE OF NEW YORK
I agree to the following form of contact:
TO
_______ exchange of correspondence
_______ personal meeting
GREETINGS:
_______ telephone call
_______ other (specify)
___________________
I hereby release the intermediary and the Courtbusiness andliabilitybeing laid aside, you and each of you attend before
WE COMMAND YOU, that all from any excuses resulting from this contact.
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of___________________________ in the
, 20
, at
o'clock
noon, and at any recessed
___________________________
or adjourned date, to testify and give evidence as a witness in this action on the part of the
(Signed)
(Intermediary)
______________________________________________________________
(Address)
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
DATED this ____your failure to comply.
result of day of ______________________, 20 ______.
********************************************************************
Witness, Honorable
, one of the Justices of the
I HEREBY REFUSE CONTACT with my _____________________________
Court in
County,
day of
, 20
(relationship)
I acknowledge receipt of an application from the State of Wyoming Adoption Intermediary Commission for my
us in the event I should ever desire to have contact with this individual. must sign above and type name below) the records
(Attorney It is my present desire that
remained sealed and my anonymity preserved.
Attorney(s) for
_________________________
(Signed)
__________________________
(Intermediary)
Office and P.O. Address
________________________________________________________________
(Address)
DATED this ___ day of _________________________, 20 ______.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
_________________________________________________________________
Additional comments: ________________________________________________
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