COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF STARK COUNTY, OHIOJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ADOPTION OF(Name after adoption)CASE NO.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .APPLICATION FOR APPROVAL OF ASSESSORTHE PEOPLE OF THE STATE OF NEW YORK TOThe attorney for the prospective adoptive parents requests that the Court approveas the assessor.GREETINGS:Attorney for Prospective Adoptive ParentsWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomJUDGMENT ENTRY APPROVING APPOINTMENT OF ASSESSORYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.The Court hereby approvesas theassessor and orders this assessor to conduct a homestudy and to make a report to the Court in, one of the Justices of theCourt in Witness, Honorableday of, 20 County,writing, together with recommendations concerning the adoption and the prospective adoptiveparents.(Attorney must sign above and type name below)The assessor shall prepare and file a homestudy at least 10 days before the petition forAttorney(s) foradoption will be heard, which hearing date is.Office and P.O. AddressHON. ROBERT D. HOROWITZ PROBATE JUDGETelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:SCPC FORM 18.10 -APPLICATION AND JUDGMENT ENTRY APPROVAL OF ASSESSOR5/98American LegalNet, Inc. www.USCourtForms.com