Joint Declaration {658.00}

PROBATE COURT OF SHELBY COUNTY, OHIO IN THE MATTER OF THE DECLARATION OF CASE NO. Name of Alleged Father JOINT DECLARATION [R.C. 2105.25] The Declarants jointly petition the Court for an order declaring Name of Alleged Father to be the father of Name of adult child , his adult child over the age 23. The Declarants further state: That this request is made freely, and voluntarily by all parties before the Court; that the adult child's birth certificate is attached and does not designate anyone as father; that genetic, test results are attached and confirm this declaration; that if the adult child's mother is unable to appear because of death or incompetence; her death certificate or guardianship letters of authority are attached; and that it is in the best interest of the man and adult child that this order issue. Signature of alleged Father Printed Name of alleged Father Address of alleged Father City, State, Zip Code Telephone Number Signature of Adult Child Printed Name of Adult Child Address of Adult Child City, State, Zip Code Telephone Number Signature of Mother of Child, if appearing Printed Name of Mother of Child, if appearing Address of Mother of Adult Child, if appearing City, State, Zip Code Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com H.C. FORM 658.00 - JOINT DECLARATION 02/10/03