Petition For Adoption Of Minor {18.0}

ePC-A-18.0 (Rev. 12-2009) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY, JUDGE IN THE MATTER OF THE ADOPTION OF Name after adoption CASE NO. PETITION FOR ADOPTION OF MINOR [R.C. 3107.05] The undersigned petitions to adopt a minor, and to change the name of the minor to The petitioner states the following: PETITIONER Full Name: Full Name: Place of Residence: Street Address , . Age Age City or Village or Township if unincorporated area County Post Office State Zip Code Duration of residence Marital Status: Relationship of Minor to Petitioner: Date and Place of Marriage: The petitioner has facilities and resources suitable to provide for the nurture and care of the minor and it is the desire of the petitioner to establish the relationship of parent and child with the minor. MINOR TO BE ADOPTED Birth Name: Place of Birth: Date of Birth: Property and Value: day of . The minor is living in the home of the petitioner, and was placed therein for adoption on the , by The minor is not living in the home of the petitioner, and resides at . The minor will be an adopted person as defined in R.C. 3107.39; The minor will be an adopted person as defined in R.C. 3107.45; FORM e18.0 - PETITION FOR ADOPTION OF MINOR American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. A certified copy of the birth certificate of the minor is filed with this petition or is not available due to the following: . A Preliminary Estimate Accounting (Form 18.9), if required, is filed with this petition. The minor is in the permanent custody of whose address is The guardian ad litem during the permanent custody proceedings was whose address is The attorney representing the minor during the permanent custody proceedings was whose address is PERSONS OR AGENCIES WHOSE CONSENT TO THE ADOPTION IS REQUIRED Name: Address: Name: Address: Relationship: Relationship: Age, if minor Consent filed Age, if minor Consent filed , the agency has permanent custody of the minor filed under, Court - County . . . , Case No. . Consent filed PERSONS WHOSE CONSENT TO THE ADOPTION IS NOT REQUIRED No person has timely registered pursuant to R.C. 3107.062 as a putative father of the minor born on or after January 1, 1997. Attached is Ohio Department of Human Services Form 1697. A B The consent of Name Address Address Relationship Relationship The consent of Name is/are not required because: A B The parent has failed without justifiable cause to provide more than de minimis contact with the minor for a period of at least one year immediately preceding the filing of the adoption petition or the placement of the minor in the home of the petitioner. The parent has failed without justifiable cause to provide for the maintenance and support of the minor as required by law or judicial decree for a period of at least one year immediately preceding the filing of the adoption petition or the placement of the minor in the home of the petitioner. State other grounds under R.C. 3107.07 (includes putative father of the minor born before January 1, 1997.) American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. Attorney for Applicant Petitioner Typed or Printed Name Typed or Printed Name Street Address Petitioner City State Zip Code Typed or Printed Name Phone Number (include area code) Attorney Registration No. Street Address City State Zip Code Phone Number (include area code) American LegalNet, Inc. www.FormsWorkFlow.com