COURT OUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... .. : : Index No. Calendar No. PROBATE COURT OF MONTGOMERY COUNTY, OHIO : ALICE O. McCOLLUM, JUDGE JUDICIAL SUBPOENA Plaintiff(s) -against- : ADOPTION OF : CASE NO. (Name after adoption) : Defendant(s) : .................................................... ADOPTION CERTIFICATE FOR PARENTS HE PEOPLE OF THE STATE OF NEW YORK This is to certify, that in an action pending in this Court, on a petition filed by O REETINGS: to adopt a minor, satisfactory evidence excuses being laid prove, and each of you attend before WE COMMAND YOU, that all business and was submitted toaside, you andthe Court found, that the minor , e Honorable at the Court was born on located at the day of , , at unty of room , on the day of , 20 , at o'clock in the noon, and at any recessed and that all necessary proceedings relative to an the part of the adjourned date, to testify and give evidence as a witness in this action onadoption were complied with; and the Court on the day of , , decreed that the minor is legally adopted Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to by e party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a ult of your failure to comply. and the minor's name is changed to in the records of the Court. Witness, Honorable urt in County, day of , one of the Justices of the , 20 (Attorney must sign above and type name below) WITNESS my signature and seal of said Court, Attorney(s) for this day of , . Alice O. McCollum, Probate Judge Office and P.O. Address By: Deputy Clerk Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: FORM 18.8 - ADOPTION CERTIFICATE FOR PARENTS American LegalNet, Inc. www.USCourtForms.com 10/01/97