PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. MCCOLLUM, JUDGE ADOPTION OF ________________________________________________________________________________ (Name after adoption) CASE NO. ____________________ NOTICE OF HEARING ON PETITION FOR ADOPTION Notice must be served not less than 20 days before the date of the hearing [R.C. 3107.11] To: ______________________________________________________ (Give Names and Addresses) You are hereby notified that on the __________ day of __________________, 20___, ___________________________________ ___________________________, filed in this Court a Petition for Adoption of _______________________________________, a minor, whose date of birth is ___________________________, and for change of the name of the minor to_____________________________________. This Court, located at 41 North Perry Street, Dayton, OH 45422-2155 will hear the petition on the _________ day of ________________________, 20____, at ______________ o'clock ____.M. It is alleged in the petition, pursuant to R.C. 3107.07, that the consent of _____________________________________________ (Name) is not required due to the following: That person is a parent who has failed without justifiable cause to provide more than de minimis contact with the minor for a period of at least one year immediately preceding the filing of the adoption petition or the placement of the minor in the home of the petitioner. That person is a parent who has failed without justifiable cause to provide for the maintenance and support of the minor as required by law or judicial decree for a period of at least one year immediately preceding the filing of the adoption petition or the placement of the minor in the home of the petitioner. State other grounds under R.C. 3107.07 (includes putative father of the minor born prior to January 1, 1997). _________________________________________________________________________________________________ "A FINAL DECREE OF ADOPTION, IF GRANTED, WILL RELIEVE YOU OF ALL PARENTAL RIGHTS AND RESPONSIBILITIES, INCLUDING THE RIGHT TO CONTACT THE MINOR, AND, EXCEPT WITH RESPECT TO A SPOUSE OF THE ADOPTION PETITIONER AND RELATIVES OF THAT SPOUSE, TERMINATE ALL LEGAL RELATIONSHIPS BETWEEN THE MINOR AND YOU AND THE MINOR'S OTHER RELATIVES, SO THAT THE MINOR THEREAFTER IS A STRANGER TO YOU AND THE MINOR'S FORMER RELATIVES FOR ALL PURPOSES. IF YOU WISH TO CONTEST THE ADOPTION, YOU MUST FILE AN OBJECTION TO THE PETITION WITHIN FOURTEEN DAYS AFTER PROOF OF SERVICE OF NOTICE OF THE FILING OF THE PETITION AND OF THE TIME AND PLACE OF HEARING IS GIVEN TO YOU. IF YOU WISH TO CONTEST THE ADOPTION, YOU MUST ALSO APPEAR AT THE HEARING. A FINAL DECREE OF ADOPTION MAY BE ENTERED IF YOU FAIL TO FILE AN OBJECTION TO THE ADOPTION PETITION OR APPEAR AT THE HEARING." By:_______________________________________________ Deputy Clerk 18.2 - NOTICE OF HEARING ON PETITION FOR ADOPTION Eff. Date: January 1, 2010 American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. ____________ The State of Ohio, Montgomery County Probate Court I hereby certify that I caused a copy of the within notice to be mailed, by certified mail, to the last known address of ________________________________________________________________________________________________________ At _____________________________________________________________________________________________________ ________________________________________________________________________________________________________ At _____________________________________________________________________________________________________ ________________________________________________________________________________________________________ ____________________________,Probate Judge By: ____________________________________ Deputy Clerk RETURN ___________________________, County, Ohio ______________________________, 20_____ 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 _____________________________________________________________________________________________ ________________________________________________________________________________________________________ ____________________________________________ Sheriff $ _________ $ _________ FEES Service and return, 1st name, ____ Additional names, at ____________________________________________ Deputy Sheriff ____ Miles traveled, at ________________________ Total $ _________ __________ $ __________ ____________________________________________ Name ____________________________________________ Title ____________________________________ 18.2 - NOTICE OF HEARING ON PETITION FOR ADOPTION Eff. Date: January 1, 2010 American LegalNet, Inc. www.FormsWorkFlow.com