PROBATE COURT OF WOOD COUNTY, OHIO David E. Woessner, Judge In the Matter of the ADOPTION of:_____________________________________________________ (Child's Name After Adoption) Case No: ______________________ Date: _________________________ ORDER GRANTING PETITION Upon request of the Petitioner for release of information concerning an adoption proceeding and a subsequent order to ________________________________ and the Department of Health to perform (Agency) the tasks required by R.C. 3107.41, the Court finds that the agency has reported that Petitioner's biological parent(s)/sibling(s) has/have [circle appropriate language] filed an effective release which has not been withdrawn and the agency has provided the Court with a copy of the identifying information. THE COURT HEREBY GRANTS the Petition in relation to said biological parent(s)/siblings(s) [circle appropriate language] and informs Petitioner of the adoption and that the adoption proceeding took place in _______________________ Probate Court and hereby orders that ________________ (County) ________________________________ release said identifying information to the Petitioner accordingly. (Agency) There being no further matters for consideration, this case is hereby closed. Date Journalized:___________________ ______________________________________ Judge David E. Woessner FORM 40.0E - ORDER GRANTING PETITION Crensch$\forms\40.0E 400e 8/23/01 American LegalNet, Inc. www.USCourtForms.com