Ariz. R. P. Juv. Ct. Form 7

As amended through December 3, 2024

Form 7 - Confidential Verified Parent Information Form

Person Filing:_____________________

Address (if not protected):__________

City, State, Zip Code:______________

Telephone:_______________________

Email Address:____________________

Representing [ ] Self or Attorney for [ ]

State Bar No. (if any):______________

_____________________COURT OF ARIZONA

IN______________COUNTY

In the Matter of:	Case Number:_____
_______________________________	CONFIDENTIAL VERIFIED PARENT INFORMATION FORM [Form 7]
_______________________________
_______________________________
(Names of Child(ren) under 18 years of age)	(Assigned to Hon____________. Division______________)

This form must be filed under seal with the juvenile court clerk not later than 10 days before the adoption hearing. Please use additional sheets if necessary. If the child is a ward of the court, DCS must complete this form. If the child is not a ward of the court, the prospective adoptive parent must complete this form. A separate form is required for each child with different biological parents. Do not add to this form other confidential information from the adoption case, including but not limited to the name(s) the child/ren will bear after adoption. Include the name of the prospective adoptive parent only if that person signs this form.

Child/ren's Full Name Child/ren's Date of Birth

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

Parents' Information:

Mother's Full Name Date of Birth Social Security Number

_________________________________________________

Other Known Name For Mother:

_________________________________________________

Mother's Last Known Mailing Address and Email Address:

_________________________________________________

Father's Full Name Date of Birth Social Security Number

_________________________________________________

Other Known Name For Father:

_________________________________________________

Father's Last Known Mailing Address and Email Address:

_________________________________________________

Child Support Order Information:

The above-named child/ren are subject to a child support order. ____Yes ____No ____Unknown

If yes, please provide the following information: The child support order was issued:

On this date:_____________________________________

In this county and state:

Under this case number:

ATLAS Number:

VARIFICATION: I declare under penalty of perjury that the foregoine is true and correct.

Signature of the person completing this form and the date:

____________________________ ________________________________

Prospective Adoptive Parent Date DCS/by Date

Ariz. R. P. Juv. Ct. Form 7

Amended Dec. 08, 2021, effective 7/1/2022; amended Aug. 29, 2022, effective 1/1/2023.