PROBATE COURT OF HAMILTON COUNTY, OHIO RALPH WINKLER, JUDGE ADOPTION OF____________________________________________________________________ (Name after adoption) CASE NO.____________________________ PETITION FOR ADOPTION OF MINOR [R.C. 3107.05] The undersigned petitions to adopt_____________________________________________________________________, a minor, and to change the name of the minor to___________________________________________________________. PETITIONER The petitioner states the following: Full Name:________________________________________________________________________ Age____________ Full Name:________________________________________________________________________ Age____________ Place of Residence:_________________________________________________________________________________ Street Address _________________________________________________________________________________________________ _________________________________________________________________________________________________ Post Office State Zip Code Duration of residence Marital Status:__________________________ Date and Place of Marriage:_____________________________________ Relationship of Minor to Petitioner:______________________________________________________________________ The petitioner has facilities and resources suitable to provide for the nurture and care of the minor and it is the desire of the petitioner to establish the relationship of parent and child with the minor. MINOR TO BE ADOPTED Birth Name:___________________________________________ Date of Birth:__________________________________ Place of Birth:__________________________________________ Property and Value:____________________________ The minor is living in the home of the petitioner, and was placed therein for adoption on the ________ day of ____________, ______ by _____________________________________________________________________ The minor is not living in the home of the petitioner, and resides at______________________________________ __________________________________________________________________________________________ A certified copy of the birth certificate of the minor is filed with this petition or is not available due to the following: _________________________________________________________________________________________________ ________________________________________________________________________________________________. A Preliminary Estimate Accounting (Form 18.9), if required, is filed with this petition. American LegalNet, Inc. www.FormsWorkFlow.com PAGE 1 OF 3 FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR 3/01/17 CASE NO. _____________ The minor is in the permanent custody of__________________________________________________________ whose address is__________________________________________________________________________________. The guardian ad litem during the permanent custody proceedings was __________________________________ whose address is __________________________________________________________________________________. The attorney representing the minor during the permanent custody proceedings was _______________________ _________________________________________________________________________________________________ whose address is __________________________________________________________________________________. PERSONS OR AGENCIES WHOSE CONSENT TO THE ADOPTION IS REQUIRED Name:___________________________ Relationship:___________________Age, if minor _________ Address:_______________________________________________________ Consent filed Name:___________________________ Relationship:___________________Age, if minor _________ Address :______________________________________________________ Consent filed _____________________________________________________________, the agency has permanent Custody of the minor filed under _________________________, _________ Consent filed PERSONS WHOSE CONSENT TO THE ADOPTION IS NOT REQUIRED A No person has timely registered pursuant to R.C. 3107.062 as a putative father of the minor. Attached is Ohio Department of Human Services Form 1697. The consent of________________________________________________________________________ Name Address Relationship The consent of________________________________________________________________________ Name Address Relationship B is/are not required because: A B The parent has failed without justifiable cause to provide more than de minimis contact with the minor for a period of at least one year immediately preceding the filing of the adoption petition or placement of the minor in the home of the petitioner. The parent has failed without justifiable cause to provide for the maintenance and support of the minor as required by law or judicial decree for a period of at least one year immediately preceding the filing of the adoption petition or the placement of the minor in the home of the petitioner. A Preliminary Estimate Accounting (Form 18.9), if required, is filed with this petition. _____________________________________________________________________________ _____________________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com PAGE 2 OF 3 FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR 3/01/17 CASE NO. __________ __________________________________________ Attorney for Petitioner __________________________________________ Typed or Printed Name __________________________________________ Street Address __________________________________________ City State Zip Code __________________________________________ Phone Number (include area code) Attorney Registration No. _____________________ _____________________________________________ Petitioner _____________________________________________ Typed or Printed Name _____________________________________________ Petitioner _____________________________________________ Typed or Printed Name _____________________________________________ Street Address _____________________________________________ City State Zip Code __________________________________________ Phone Number (include area code) American LegalNet, Inc. www.FormsWorkFlow.com PAGE 3 OF 3 FORM 18.0 ­ PETITION FOR ADOPTION OF MINOR 3/01/17 PROBATE COURT OF HAMILTON COUNTY, OHIO RALPH WINKLER, JUDGE ADOPTION OF____________________________________________________________________ (Name after adoption) CASE NO.________________________________ NOTICE OF HEARING ON PETITION FO