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- REQUEST FOR RESCISSION OF RELINQUISHMENT - Dss Cahwnet
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Dged by CDSS) TO AGENCY: AGENCY NAME ADDRESS TELEPHONE NUMBER ( ) TO PARENT: Your request to rescind your relinquishment must be confirmed in writing. Complete and sign the below portion of this form and return the entire form to the above agency address within 14 days after you receive it, or by . If this form is not returned by this date, your request for rescission is cancelled. I, mother/father of (NAME.
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