Petition for Termination of Parental Rights Completed Form Examples and Samples

Memo to File: Regarding the matter of the Matter of James A. Miller vs. Samantha L. Reed. We are moving forward with the formal petition in the Superior Court of Jefferson County under case docket number 2026-CV-0492. Per my consultation with the petitioner today, January 14, 2026, he is seeking the termination of parental rights for the respondent, Samantha L. Reed. The petition will be officially timestamped for filing as of 9:15 AM on January 15, 2026. The child involved is Leo Thomas Miller, born on June 12, 2018, in the city of Springfield, Greene County. Regarding parental history, the mother's name prior to her first marriage was Samantha Lynn Vance. The father, James, has provided his information for the record; his name prior to his first marriage was James Arthur Miller, though his legal name remains unchanged. We need to ensure the court clerk receives the supplemental evidentiary filing along with the primary petition to ensure the file is processed correctly in Department 4 of the Family Division. The father signed the final declaration document in my office this morning, January 14, 2026. Please ensure all identifiers are accurate before submission to the county clerk.