Application By Relative For Approval Of Placement Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application By Relative For Approval Of Placement Form. This is a Ohio form and can be use in Butler County (Court Of Common Pleas).
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Tags: Application By Relative For Approval Of Placement, 316, Ohio County (Court Of Common Pleas), Butler
PROBATE COURT OF BUTLER COUNTY, OHIO
IN THE MATTER OF THE PLACEMENT OF
(Current name of child)
CASE NO.
APPLICATION BY RELATIVE FOR APPROVAL OF PLACEMENT
[R.C. 5103.16(D)]
Applicant,
, who resides at
(Name of relative)
represents that applicant is the
(Address of relative)
of a child whose date of birth is
(Relationship to child)
and
(Birthdate of child)
who resides at
.
(Address of child)
Applicant states that: (Check whichever applicable)
the mother of the child is deceased.
the father of the child is deceased.
the mother as established pursuant to R.C. 3111.02(A) has abandoned the child as determined under R.C.
3107.07(A).
the father as established pursuant to R.C. 3111.02(A) has abandoned the child as determined
under R.C. 3107.07(A).
Applicant proposes that said child be placed for adoption and states that such proposed placement would be in the
best interest of the child.
Applicant requests that the Court order an independent home study of the proposed placement to be conducted as
provided in section 3107.031 of the Revised Code.
Applicant consents to the proposed placement.
Applicant requests that a hearing be set to allow the Applicant to appear before the Court concerning the proposed
placement.
W HEREFORE, Applicant prays that such proposed placement be approved.
Signature of Relative
BCPC FORM 316 - APPLICATION BY RELATIVE FOR APPROVAL OF PLACEMENT
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