Relative Applcation For Placement {18.RP1}

ePC-A-18.RP1 (Rev. 11-2010) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY, JUDGE IN THE MATTER OF THE PLACEMENT OF : Case No. RELATIVE APPLICATION FOR PLACEMENT The undersigned applicant-petitioner, who is related to the above-mentioned child as follows: , applies to the Court to place said child for the purpose of adoption. The child was born at , . on the day of Applicant 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 birthparents are unable to provide. Applicant alleges that birthparent, is deceased or has failed without justifiable cause either to communicate with said minor or to provide for the maintenance and support of said minor as required by law or judicial decree for a period of at least one year immediately preceding the filing of the adoption petition. Further, applicant prays that the placement be approved. Attorney for Petitioner Petitioner-Applicant Typed or Printed Name Typed or Printed Name Address Address Phone Number (include area code) Phone Number (include area code) For Entry form see ePC-A-19.4Ae FRANKLIN COUNTY FORM e18.RP1 - RELATIVE APPLICATION FOR PLACEMENT American LegalNet, Inc. www.FormsWorkFlow.com