PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF THE ADOPTION OF (Name after Adoption) CASE NO. PETITION FOR ADOPTION OF ADULT [R.C. 3107.02] The undersigned respectfully petitions the Court to adopt ______________________________, an adult, and to have the adult's name changed to ___________________________________. The Petitioner may adopt because the adult: is totally and permanently disabled. is determined to be a person with an intellectual disability. had established a child-foster caregiver, kinship caregiver, or child-stepparent relationship with the petitioner as a minor. was, at the time of the adult's eighteenth birthday, in the permanent custody of or in a planned permanent living arrangement with a public children services agency or a private child placing agency is the child of the spouse of the petitioner Attorney for Petitioner Typed or Printed Name Street Address City State Zip Code Telephone Number (include area code) Attorney Registration No. Petitioner Typed or Printed Name Petitioner Typed or Printed Name Street Address City State Zip Code Telephone Number (include area code) ENTRY This cause is set for hearing on the day of ____________________________, 20____at______________________o'clock _____.m. PROBATE JUDGE FORM 19.0 ­ PETITION FOR ADOPTION OF ADULT Amended: March 1, 2017 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com