FORM 19.16 Notice of Adoption Hearing

IN THE COURT OF COMMON PLEAS OF

__________________ COUNTY, PENNSYLVANIA

IN RE: : No.

ADOPTION OF

NOTICE OF ADOPTION HEARING

To

(Natural Parent(s))

(Street Address)

(City, State, Zip Code)

NOTICE is hereby given that a hearing in the above adoption matter has been scheduled as

follows: [Date: Time:Place:]

If you desire to oppose the adoption petition, you have the right to appear at the hearing and have

the further right to be represented by an attorney.

You need not attend the hearing if you do not oppose the adoption petition, but in such event, you

are advised that a decree of adoption will likely be entered in your absence and your rights as

natural parent(s) of the child will be terminated.

__________________

Date of this Notice

__________________

Petitioner Pro se