Probate Court of Lake County,Ohio MARK J. BARTOLOTTA, JUDGE ADOPTION OF _________________________________________________________ CASE NUMBER ______________ AFFIDAVIT OF UNKNOWN RESIDENCE _______________________________________________, being first duly sworn (petitioner(s)/natural parent) according to law, deposes and says that the residence of ______________________________, (natural parent/parents) the natural parent of __________________________________ is unknown and cannot be (name of minor before adoption) ascertained with reasonable diligence, even though I have exercised same. ____________________________________ (petitioner/natural parent) ___________________________________ (petitioner/natural parent) Sworn to before me and subscribed in my presence this _________ day of ________________, 20 _____. ___________________________________ Notary Public/Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com