PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE IN THE MATTER OF THE DECLARATION OF Name of Alleged Father CASE NO. JOINT DECLARATION [R.C. 2105.25] The Declarants jointly petition the Court for an order declaring Name of Alleged Father to be the father of , his adult child over the age 23. Name of adult child The Declarants further state: That this request is made freely, and voluntarily by all parties before the Court; that the adult childs birth certificate is attached and does not design ate anyone as father; that genetic, test results are attached and confirm this declaration; that if the adult childs mother is unable to appear because of death or incompetence; her death certificate or guardianship letters of authority are attached; and that it is in the best interest of the man and adult child that this ord er issue. Signature of alleged Father Signature of Adult Child Printed Name of alleged Father Printed Name of Adult Child Address of alleged Father Address of Adult Child City, State, Zip Code City, State, Zip Code Telephone Number Telephone Number Signature of Mother of Child, if appearing Printed Name of Mother of Child, if appearing Address of Mother of Adult Child, if appearing City, State, Zip Code Telephone Number M.C. FORM 28.0 - JOINT DECLARATION 05/24/05 American LegalNet, Inc. www.USCourtForms.com