Statement Of Adopted Person

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.STATEMENT OF ADOPTED PERSONJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)CASE NO. CHILD'S NAME AFTER ADOPTION THE CHILD NAMED IN THIS ADOPTION IS:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOA minor who became available or potentially available for adoption on or before September 18, 1996 and at least one of the biological parents consented to the adoption or a probate court entered a finding that the biological parent (s) signature was not needed (O.R.C. 3107.39). A minor who became available for adoption after September 18, 1996 (O.R.C. 3107.45).3107.39GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable3107.45,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomEXCLUSIONS FOR ODHS 1693 DISCLOSUREYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Foreign adoption finalized in another country and re-finalized in Ohio. Foreign adoption finalized in Ohio only. Stepparent adoption. Involuntary surrender/court commitment Other (please specify) , one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>