PROBATE COURT OF WARREN COUNTY, OHIO ____________________, JUDGE IN THE MATTER OF THE ADOPTION OF ____________________________________________ (Name after Adoption) CASE NO. _______________________ PETITION FOR ADOPTION OF ADULT [R.C. 3107.02] The undersigned respectfully petitions the court for permission to adopt _______________________________ an adult and to have the adult's name changed to ________________________________________________ The Petitioner may adopt because the adult: is totally and permanently disabled. is determined to be a person with an intellectual disability. had established a child-foster caregiver, kinship caregiver, or child-stepparent relationship with the petitioner as a minor. was, at the time of the adult's eighteenth birthday, in the permanent custody of or in a planned permanent living arrangement with a public children services agency or a private child placing agency. is the child of the spouse of the petitioner. ____________________________________ Attorney for Petitioner ____________________________________ Typed or Printed Name ____________________________________ Address ____________________________________ City State Zip Code ____________________________________ Phone Number (include area code) Attorney Registration No. _________________ _____________________________________ Petitioner ____________________________________ Typed or Printed Name ____________________________________ Address ______________________________________ City State Zip Code _____________________________________ Phone Number (include area code) ENTRY This cause is set for hearing on the _______ day of ________________________, 20 _______ At _____________________ o'clock ______. M. _________________________________________ PROBATE JUDGE FORM 19.0 PETITION FOR ADOPTION OF ADULT Amended: March 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com