Probate Court of Lake County, Ohio MARK J. BARTOLOTTA, JUDGE ADOPTION OF __________________________________________________________ (Name after adoption) CASE NUMBER______________________ PETITION FOR ADOPTION OF ADULT The undersigned respectfully petitions the court for permission to adopt _________________________________ an adult and to have the adult's name changed to ______________________________________. Petitioner says he/she may adopt the adult because the adult is totally and permanently disabled. is determined to be a mentally retarded person. had establish a child-foster parent or child-stepparent relationship with the petitioner as a minor. _______________________________ Attorney for Applicant _______________________________ Signature of Attorney _______________________________ Address _______________________________ City, State, Zip Code _______________________________ Phone Number (include area code) ______________________________ Petitioner ______________________________ Signature of Petitioner ______________________________ Address ______________________________ City, State, Zip Code ______________________________ Phone Number (include area code) 19.0 PETITION FOR ADOPTION OF ADULT American LegalNet, Inc. www.FormsWorkFlow.com