PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE IN THE MATTER OF THE GUARDIANSHIP OF __________________________________ CASE NO. ______________________ NOTICE OF HEARING ON APPLICATION FOR APPOINTMENT GUARDIAN OF MINOR To Parent, Known Next of Kin and Person Having Custody [R.C. 2111.04] To _____________________________________________________________________________________ Address ________________________________________________________________________________ To _____________________________________________________________________________________ Address ________________________________________________________________________________ To _____________________________________________________________________________________ Address ________________________________________________________________________________ You are hereby notified that _____________________________________________________ filed in this Court an application for appointment of a (limited) guardian of the (person and estate) of the minor. The application will be for hearing before the Probate Court in ______________________________________ _______________________________________________________________________________________ On the ___________ day of _________________________, 20____ at _______________ o'clock ______.M. Witness my signature and the seal of the Court, this ______ day of ______________, 20_____ (Seal) Judge Jack R. Puffenberger By: Deputy Clerk FORM 16.4 NOTICE OF HEARING ON APPLICATION FOR APPOINTMENT GUARDIAN OF MINOR TO PARENT, KNOWN NEXT OF KIN AND PERSON HAVING CUSTODY Amended: March 15, 2016 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com (Reverse of Form 16.4) CASE NO. ___________ __________________County, Ohio _____________________, 20_____ RETURN Received this writ on the________day of __________________________________, 20___, at _________o'clock ___.M., and on the day of __________________________________, 20___, I served the same by delivering a true copy thereof personally to ______________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ ______________________________________ ____________Fees______________________ Service and return, 1 name $______________ ________Additional names, at______________ ________Miles traveled, at ________________ ______________________________________ Total $ _________________ ______________________________________ Sheriff ______________________________________ st ______________________________________ ______________________________________ ______________________________________ ______________________________________ AFFIDAVIT OF SERVICE The State of Ohio, ___________________________ County. _________________________________________________, being first duly sworn, says that on the __________ day of _____________________, 20_____, the within notice was served by delivering a true copy thereof personally to _________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Sworn to before me and signed in my presence, this _______ day of ____________________________, 20____ ______________________________________ ______________________________________ FORM 16.4 NOTICE OF HEARING ON APPLICATION FOR APPOINTMENT GUARDIAN OF MINOR TO PARENT, KNOWN NEXT OF KIN AND PERSON HAVING CUSTODY Amended: March 15, 2016 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com