Birth Parent Affidavit (Expedited Relinquishment) {JDF 480}

JDF 353 2 / 18 CONSENT FOR SEARCH PURSUANT TO 24719 - 5 - 304 (1)(b)(I)(D) and (E), C.R.S. District Court Denver Juvenile Court County, Colorado Court Address: IN THE MATTER OF THE ADOPTION OF : Birth Name of Adoptee (If known) A ND CONCERNING Current Legal Name of Petitioner COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom CONSENT FOR SEARCH PURSUANT TO 247 19 - 5 - 304(1)(b)(I)(D) and (E), C.R.S. If an adult adoptee is not deceased, this section must be completed if the petitioner is an adult descendant of the adoptee or the adoptive parent, spouse of an adoptee, adult stepchild, or adopted adult sibling of an adoptee: I, , the adoptee, consent to a confidential intermediary being authorized to inspect confidential relinq uishment and adoption records and post - adoption records pursuant to 24719 - 5 - 304(1)(b)(I)(D) and (E), C.R.S., upon motion to the court by my adult descendant, my adoptive parent, my spouse, my adult stepchild, or my adopted adult sibling. VERIFICATION AND ACKNOWLEDGEMENT I swear/affirm under oath that I have read the foregoing Consent and that the statements set forth therein are true and correct to the best of my knowledge. Printed name of Petitioner (adoptee) Signature of Petitioner (adoptee) SUBSCRIBED and swor n before me by in the County of , State of this day of , 20 . My commission expires: Deputy Clerk/ Notary Public If this is a request by a biological grandparent of an adoptee and the adoptee's biological parent is not deceased, this section must be completed: I, , the biological parent, consent to a confidential intermediary being authorized to inspect confidential relinquishment and adoption records and post - adoption records pursuant to 24719 - 5 - 304(1)(b)(I)(D) and (E), C.R.S., upon motion to the court by my biolog ical child's biological grandparent. VERIFICATION AND ACKNOWLEDGEMENT I swear/affirm under oath that I have read the foregoing Consent and that the statements set forth therein are true and correct to the best of my knowledge. Printed name of Petitioner (biological grandparent) Signature of Petitioner (biological grandparent) SUBSCRIBED and swor n before me by in the County of , State of this day of , 20 . My commission expires: Deputy Clerk/ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com