Application For Placement {18.P1}

ePC-A-18.P1 (Rev. 11-2007) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY, JUDGE IN THE MATTER OF THE PLACEMENT OF CASE NO. APPLICATION FOR PLACEMENT Applicant resides at and hereby applies to the Court to place the above mentioned child for the purpose of adoption. The child was born at at o'clock .M. on the day of , . Applicant does not know the identity of the proposed adopting parents and states that the placement will be for the best interest of the child, because the adoptive family will be able to provide personal care advantages and financial assistance which I am unable to provide, specifically described as follows: (Please complete in your own words why you believe it is for the best interest of the child to be adopted.) Further, applicant waives any right to examine any investigation report on either the applicant or proposed adoptive parents made before or after the hearing on this application and prays that the placement be approved. Applicant Voluntarily executed before me this day of , 20 . Signature page attached Deputy Clerk FRANKLIN COUNTY FORM e18.P1 - APPLICATION FOR PLACEMENT American LegalNet, Inc. www.FormsWorkFlow.com