FORM 19.11A Notice of Hearing on Petition for Involuntary Termination of Parental Rights or on Petition to

Confirm Consent

IN THE COURT OF COMMON PLEAS OF

__________________ COUNTY, PENNSYLVANIA

IN RE: : No.

ADOPTION OF

NOTICE

A Petition has been filed asking the Court to put an end to all rights you have to your child

__________________. That hearing will be held in __________________ on

__________________ at __________________ A.M./P.M.

IF YOU DO NOT APPEAR AT THIS HEARING, THE COURT MAY DECIDE THAT YOU ARE NOT

INTERESTED IN RETAINING YOUR RIGHTS TO YOUR CHILD AND YOUR FAILURE TO APPEAR MAYAFFECT THE COURT'S DECISION ON WHETHER TO END YOUR RIGHTS TO YOUR CHILD. YOU ARE WARNED THAT EVEN IF YOU FAIL TO APPEAR AT THE SCHEDULED HEARING, THE HEARING WILL GO ON WITHOUT YOU AND YOUR RIGHTS TO YOUR CHILD MAY BE ENDED BY THE COURT WITHOUT YOUR BEING PRESENT.

YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.

LANCASTER BAR ASSOCIATION

LAWYER REFERRAL SERVICE

28 EAST ORANGE STREET

LANCASTER, PA. 17602

TELEPHONE: (717)393-0737