Petition To Recognize Foreign Adoption {19.2}

PROBATE COURT OF CUYAHOGA COUNTY, OHIO ANTHONY J. RUSSO, Presiding Judge LAURA J. GALLAGHER, Judge ADOPTION OF (Name after adoption) CASE NO. PETITION TO RECOGNIZE FOREIGN ADOPTION [R.C. 3107.18] [Check applicable boxes, complete blanks, strike inapplicable language, and attach supporting documentation] The Petitioner(s) is/are the adoptive parent(s) of a minor child pursuant to a Foreign Decree or Certificate of Adoption and state that: PETITIONER(S) Petitioner's Full Name: Petitioner's Full Name: Residence: Duration of Residence: Marital Status: Date and Place of Marriage: ADOPTED CHILD Name of Child before Adoption: Name of Child after Adoption: Date and Place of Birth: Attached is a certified copy of the child's Birth Certificate, and if not in English, also attached is a translation certified as to its accuracy by the translator. A Foreign Decree or Certificate of Adoption in compliance with the laws of the Country of issued by (Name of Court) in Case Number the day of , 20 . was on FORM 19.2 ­ PETITION TO RECOGNIZE FOREIGN ADOPTION Effective Date: March 1, 2014 American LegalNet, Inc. www.FormsWorkFlow.com (Reverse of Form 19.2) CASE NO. Attached is a certified copy of the Foreign Decree or Certificate of Adoption which has been verified and approved by the Immigration and Naturalization Service of the United States, and if not in English, also attached is a translation certified as to its accuracy by the translator. Attached is a fully completed Ohio Department of Health, Division of Vital Statistics, Certificate of Adoption. The Petitioner(s) state that giving effect to the Foreign Decree or Certificate of Adoption would not violate the public policy of the State of Ohio and respectfully pray for the following Order(s): An Order that the child's name shall be changed to: An order to the Ohio Department of Health to issue a new birth record for the adopted person under R.C. 3705.12(A)(1) Other Attorney for Petitioner Petitioner Typed or Printed Name Typed or Printed Name Street Address Petitioner City State Zip Code Typed or Printed Name Telephone Number (include area code) Attorney Registration No. Street Address City State Zip Code Telephone Number (include area code) FORM 19.2 ­ PETITION TO RECOGNIZE FOREIGN ADOPTION PAGE 2 Effective Date: March 1, 2014 American LegalNet, Inc. www.FormsWorkFlow.com