PROBATE COURT OF SUMMIT COUNTY, OHIO ADOPTION OF: CASE NO. FINAL ORDER OF ADOPTION OF ADULT This day this cause came on to be heard on the petition of to adopt , an adult, and on the evidence. On consideration thereof the Court finds (R.C. 3107.02(B)) and that the adoption should be granted. It is so ordered that the name of the adopted adult be changed to . It is therefore further ordered that a final decree of adoption be, and the same hereby is entered herein. It is further ordered that at that time a Certificate of Adoption, certified by the Court, be forwarded to the State Department of Health at ________________________________________________________________________________. IT IS SO ORDERED. DATE JUDGE ELINORE MARSH STORMER Form 19.1 American LegalNet, Inc. www.FormsWorkFlow.com