Free PC-633 - Connecticut

WAIVER OF PERSONAL SERVICE/ PARENTAL RIGHTS MATTER PC-633 REV. 8/02 TO: COURT OF PROBATE, DISTRICT OF

STATE OF CONNECTICUT COURT OF PROBATE

RECORDED (CONFIDENTIAL VOLUME):

DISTRICT NO.

IN THE MATTER OF [Name, address, zip code,and telephone number]

a minor child. PERSON WAIVING PERSONAL SERVICE [Name, address, zip code, and telephone number]

PETITIONER OF PENDING APPLICATION [Name, address, zip code, and telephone number]

An application has been presented to the Court requesting: Temporary custody of a minor Removal of parent as guardian in the matter of the minor child named above.

Termination of parental rights

The undersigned person is the parent of said minor child named above OR the father of said minor child who was born out of wedlock and is entitled to receive, by personal service, notice of hearing in said matter. By signing this waiver of personal service under the penalty of false statement,the undersigned knowingly waives his or her right to receive, by personal service, notice of hearing in the above-captioned matter which is deliverable by a state marshal, constable, or indifferent person. IN LIEU THEREOF, the undersigned agrees to receive said notice of hearing by certified mail, return receipt requested. The representations contained herein are made under the penalties of false statement. DATE: SIGNED ................................................................................................................... [Person waiving right to recieve notice of hearing by personal service] Print Name: WAIVER OF PERSONAL SERVICE/PARENTAL RIGHTS MATTER PC-633 RESET