PROBATE COURT OF BUTLER COUNTY, OHIO IN THE MATTER OF THE PLACEMENT OF (Current name of child) CASE NO. ENTRY ON PLACEMENT This day as a duly licensed assessor under the provision of section 3107.012 of the Revised Code, having made an independent home study of the proposed placement of , and having filed said home study with this Court; and The Court finding said independent home study to be in order and complete, and the Court having heard the evidence upon the application for approval of placement: It is now the order of the Court that said placement is hereby approved as of record; and It is further ordered that , as prospective adoptive parents, are granted temporary custody of pending further proceedings of adoption of said child. ENTER Date Probate Judge Attorney (Type or Print Attorney’s Name) Street City, State, Zip Code Telephone Number (Include area code) BCPC FORM 306 - ENTRY ON PLACEMENT 3/98