County Court District Court Denver Juvenile Court ________________________________ County, Colorado Court Address: IN THE MATTER OF THE PETITION OF: Parent/Petitioner:
Minor Child: to change the child's name to:
for:
COURT USE ONLY Case Number:
Attorney or Party Without Attorney (Name and Address):
Phone Number: FAX Number:
E-mail: Atty. Reg.#:
Division
Courtroom
CONSENT OF NON-CUSTODIAL PARENT
1. I, ______________________________________________, am the non-custodial parent of the minor child. 2. I understand that a Petition for the change of my child's name will be presented to this Court. 3. I understand that I have a right to participate in the hearing and to voice objection to the change of name. 4. I give up any objection and consent to the change of name. 5. I give up my right to be present at any hearing on this change of name.
I, __________________________________, swear/affirm under oath that I have read the foregoing Consent of Non-custodial Parent and that the statements set forth herein are true to the best of my knowledge and belief.
Date: __________________________
_____________________________________________ Signature of Non-custodial Parent _____________________________________________ Address _____________________________________________ City, State, Zip Code _____________________________________________
Telephone #: (home) (work) (cell)
Subscribed and affirmed, or sworn to before me in the County of ______________________, State of ________________, this ___________ day of _______________, 20 ______.
My Commission Expires: ________________________
______________________________________ Deputy Clerk/Notary Public
JDF 423 R4/07
CONSENT OF NON-CUSTODIAL PARENT (Change of Name of Minor)