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IN THE CIRCUIT COURT OF
THE STATE OF OREGON
FOR THE COUNTY OF _________
_________,)
Petitioner,) NO._____
)
) ANSWER
and)
)
_________,)
Respondent.)
[ ] I consent to the proposed adoption.
[ ] I do not consent to the proposed adoption. The court should not order the proposed adoption without my consent for the following reasons:
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_________________________
__________________
Signature
DATE:__________________
ADDRESS OR CONTACT ADDRESS:
_____________________
_____________________
TELEPHONE OR CONTACT TELEPHONE:
_____________________
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You have a right to be represented by an attorney. If you wish to be represented by an attorney, please retain one as soon as possible to represent you in this proceeding. If you meet the state's financial guidelines, you are entitled to have an attorney appointed for you at state expense. To request appointment of an attorney to represent you at state expense, you must contact the circuit court immediately. Phone ______ for further information.
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ORS 109.330