Request For Copies Of Adoption Documents {AR-41}

THE WOOD COUNTY PROBATE COURT JUDGE DAVID E. WOESSNER Request for Copies of Adoption Documents Adoptions Finalized After January 1, 1964 through September 17, 1996 Pursuant to Ohio Revised Code 3107.41 This form is to request copies of documents contained in an adoption file for an adoption finalized prior to on or after January 1, 1964. This information will not contain identifying information. This form must be accurately and completely filled out prior to the Court releasing any documents. Requests for identifying information must be pursuant to Ohio Revised Code Section 3107.41. The release of information shall be only upon the filing of the Petition for Release. Requests made other than in person to the Court, shall require the additional procedures as set forth in Form AR17ABS. The release of any information contained in an adoption file is subject to the discretion of the Probate Court and may be denied. Name: Address: City: Home Telephone: Date of Birth: Name at Adoption: Party to the Adoption: ( ) Mr. Mrs. Ms. State: Postal Code Adopted Person Parent of Adopted Minor Date Adoption Finalized or Date on Final Decree (if known): Court where Adoption Finalized: Please Check the Appropriate Box to Indicate the Type of Information Requested: Final Decree and Adoption Certificate - $7.00 Social and Medical History - $25.00 Petition for the Release of Information - $25.00 Please Attach Form 40.0 AR41 C:\Documents and Settings\josh\My Documents\Word Processor Documents\Wood County Probate\Forms\AR41.doc American LegalNet, Inc. www.USCourtForms.com Approval of the Court The Court hereby approves the foregoing release of information is in compliance with Ohio Revised Code Section 3107.17 and 3107.41. ________________________________ Judge David E. Woessner AR41 C:\Documents and Settings\josh\My Documents\Word Processor Documents\Wood County Probate\Forms\AR41.doc American LegalNet, Inc. www.USCourtForms.com