COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO CASE NUMBER: Plaintiff/Petitioner Address City ST Zip Vs Defendant/Petitioner NOTICE OF INTENT TO RELOCATE OUTSIDE OF 75 MILE RADIUS OF RESIDENCE Address City ST Zip I, , am the parent of the following minor child/ren: Name Date of Birth: Name Date of Birth: Name Date of Birth: Effective (date), I intend to relocate from: Present address: TO New address: I understand that I cannot relocate the children without first obtaining a modified parenting time order. If the parents agree to the relocation, the parents must file a motion and submit an agreed entry that modifies the parenting time and includes a provision for allocation of transportation expenses, in compliance with Local Rule DR 36. American LegalNet, Inc. www.FormsWorkFlow.com If the parents are unable to agree, the parent filing this Notice must, PRIOR TO RELOCATION, do all of the following, as set forth in Local Rule DR 23: 1.file a motion asking the Court to modify the parenting time schedule;2.set a hearing; and3.obtain a modified parenting time order.The motion must include the new residence address unless not required under R.C.3109.051(G)(2). Because relocating a child can be harmful to the parent/child relationship, the Court will not continue hearings to address a modification of the parenting schedule due to an imminent relocation except in extreme circumstances. Choose one: I have no objection to the Clerk of Courts mailing a copy of this notice to the other parent at his/her above-captioned address. The other parent has been convicted of criminal domestic violence, or pleaded guilty to criminal domestic violence, or another criminal offense involving a member of our immediate family, or has been determined to be the perpetrator of an abusive act resulting in a judicial determination that a child is an abused child. Therefore, I object to the Clerk of Courts mailing a copy of this Notice to the other parent. Signature of Parent filing this Notice INSTRUCTIONS TO THE CLERK OF COURTS Choose one: Please serve a copy of this Notice on (name) at his/her address in the caption above by ordinary mail, with a certificate of mailing. Please do not serve a copy of this Notice, but provide a time-stamped copy of the Notice to the Domestic Relations Court. The Court will then provide supplemental instructions for Service. American LegalNet, Inc. www.FormsWorkFlow.com