FORM 19.11B Notice to Petitioner of Hearing on Petition for Voluntary Relinquishment

IN THE COURT OF COMMON PLEAS OF

__________________ COUNTY, PENNSYLVANIA

IN RE: : No.

ADOPTION OF

NOTICE

TO

(Petitioner's Name)

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

. The Court has set a hearing to consider ending your rights to your child.

(name of child)

That The Court has set a hearing to consider ending your rights to your child. That hearing will

be held in (insert place, giving reference to exact room and building number or designation) on

(insert date) at (insert time).

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