Name of Person Filing Document:_ Your Mailing Address: ______ Your Telephone Number: Attorney Bar Number (if applicable): ______ Self (Without Attorney) OR Attorney Petitioner Representing
Respondent
IN THE SUPERIOR COURT OF ARIZONA
PINAL COUNTY
In the Matter of the Severance of: ) ) ) ) ) ) ) Minor Child / Children ) ____________________________________)
Case No. SV 2
PETITION FOR TERMINATION OF PARENT / CHILD RELATIONSHIP
The Petitioner allege as follows:
1. That the names and residence of the Petitioner is:
2. That the name(s), sex, date(s) and place(s) of birth and residence of the minor child(ren) is / are:
3. That the minor child(ren) is /are present in the State of Arizona:
Yes
or
No.
If no, Explain:__________________________________________________________________.
4. That the relationship of the Petitioner(s) to the minor child(ren is: _________________________________________________________________________________.
5. That the names, addresses, and the dates of birth of the parents, if known are:
__________________________________________________________________________________
6. That the person or agency having legal custody of the minor child(ren):
7. That the grounds for termination of the parent child relationship is: ( ) that __________________________________ has abandoned the child(ren) and has made no
effort to maintain a parental relationship with said child(ren). ( ) that _________________________________ has not provided support and has nor
communicated with said child(ren) for six (6) months or longer. ( ) that _________________________________ has made only token efforts to support or
communicate with said child(ren).
8. That Petitioner(s) have petitioned for the adoption of __________________________________.
WHEREFORE it is requested that the Court set the matter for hearing and that the parent / child(ren) relationship of ___________________________________ and _______________________________, _____________________, ________________________, ____________________________ be severed.
__________________________________________ Petitioner
__________________________________________ Petitioner
STATE OF ARIZONA County of Pinal
) ) ss. )
___________________________________________, being first duly sworn, says: That I have read the foregoing Petition for Termination of Parent / Child Relationship and know the contents thereof; that the matters and things therein set forth are true to the best of my own knowledge and belief. ____________________________________ Petitioner
Subscribed and sworn to before me this _________ day of _____________________, _________ ____________________________________ Notary Public
STATE OF ARIZONA County of Pinal
) ) ss. )
___________________________________________, being first duly sworn, says: That I have read the foregoing Petition for Termination of Parent / Child Relationship and know the contents thereof; that the matters and things therein set forth are true to the best of my own knowledge and belief. ____________________________________ Petitioner
Subscribed and sworn to before me this _________ day of _____________________, _________ ____________________________________ Notary Public