Entry On Pre-Placement Application {118.21}

PROBATE COURT OF HAMILTON COUNTY, OHIO RALPH WINKLER, JUDGE PLACEMENT OF (Name before placement) CASE NO. ENTRY ON PRE - PLACEMENT APPLICATION The applicants herein having requested to be approved for the placement of a child for adoption, the Court hereby authorizes to make an independent investigation into the suitability of the applicants for such placement, and directs that a report of the results of such investigation and recommendations of such investigator be made to the Court and to the Ohio Department of Human Services Compact Administrator, where applicable. Ralph Winkler, Probate Judge Approved: Attorney for Prospective Adoptive Parents Attorney Registration Number H.C. FORM 118.21 - ENTRY ON PRE-PLACEMENT APPLICATION 02/10/03 American LegalNet, Inc. www.FormsWorkFlow.com