In the interest of




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For Official Use


STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY

IN THE INTEREST OF


     

a person under the age of 18.





Consent to Use Mother’s

Name for Publication


     

Date of Birth


Case No.      



If the natural father cannot be personally served, the law requires service by publication. Publication will be in a newspaper likely to give notice to the father.
If publication is necessary, I:
 consent to the use of my name.
 do not consent to the use of my name.




Signature of Mother

     

Name Printed or Typed

     

Date

JC-1634, 11/99 Consent to Use Mother’s Name for Publication (Termination of Parental Rights) §§48.42, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.


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