Petition For Adoption Of Minor {18.0}

PROBATE COURT OF BUTLER COUNTY, OHIO IN THE MATTER OF THE ADOPTION OF CASE NO. (Name after adoption) 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 , . PETITIONER The petitioner states the following: Full Name: Full Name: Place of Residence: Street Address Age Age 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 resource 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 . The minor is living in the home of the petitioner, and was placed therein for adoption on the of , by The minor is not living in the home of the petitioner, and resides at A certified copy of the birth certificate of the minor is filed with this petition or is not available due to the following: ___________________________________________________________________________________________ FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR Amended: March 1, 2017 Discard all previous versions American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. 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, 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. Attached is Ohio Department of Jobs & Family Services Form 1697. A The consent of Name Address Relationship B The consent of Name Address Relationship 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). FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR PAGE 2 Amended: March 1, 2017 Discard all previous versions American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. ______________________ ___________________________________________ Attorney for Petitioner _____________________________________________ 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) _____________________________________________ Street Address Attorney Registration No. ______________________ _____________________________________________ City State Zip Code _____________________________________________ Phone Number (include area code) FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR PAGE 3 Amended: March 1, 2017 Discard all previous versions American LegalNet, Inc. www.FormsWorkFlow.com