IN THE COMMON PLEAS COURT OF SHELBY COUNTY, OHIO PROBATE DIVISION IN THE MATTER OF THE ADOPTION OF: __________________________ * * * ORDER TO ASSESSOR CASE NO. ______________ ********************** The Court finds that __________________________________________ is a/an __________________________________________________ in __________________ County who meets the requirements set forth in R.C. 3107.012 and, therefore, may perform the duties of assessor. The Court appoints __________________________ as the assessor to conduct a home study in this matter as required by law. The assessor shall submit to the Court a written report of the home study at least ten (10) days prior to the date of hearing. The report shall contain the assessor's opinion as to whether the petitioner(s) are suitable to adopt a minor child. The costs of the home study and other proceedings shall be paid by the petitioner(s) seeking to adopt. Upon request, the assessor shall provide the petitioner(s) seeking to adopt a copy of the report of the home study. The assessor shall delete from that copy any provisions concerning the opinion of other persons, excluding the assessor, of the persons suitability to adopt a minor. _______________________________ Judge Shelby County Common Pleas Court Probate Division American LegalNet, Inc. www.FormsWorkFlow.com