Next Of Kin Of Proposed Ward {15.0}

PROBATE COURT OF TRUMBULL COUNTY, OHIO JAMES A. FREDERICKA, JUDGE ,1 7+( 0$77(5 2) 7+( *8$5',$16+,3 2) BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB &$6( 12 BBBBBBBBBBBBBBBBBBBB 1(;7 2) .,1 2) 352326(' :$5' [R.C. 2111.04] (NOTE: Specify age and birthdate of each minor under 16 on the line containing the minor's name. List the name and address of the minor's parent, guardian or custodian on the name and address lines following the minor's address.) Service Relationship Birthdate Waived Of Minor 1. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ 2. [ ] Zip _______________ Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 3. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 4. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 5. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 6. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 7. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 8. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 9. [ ] Name _______________________________________________ _________________ __________________ Address _______________________________________________________________ Zip _______________ 10. [ ] Name ______________________________________________ _________________ ___________________ Address _______________________________________________________________ _______________________________________ Date Zip _______________ ______________________________________ Applicant 1(;7 2) .,1 2) 352326(' :$5' American LegalNet, Inc. www.FormsWorkFlow.com