PROBATE COURT OF ___________________________COUNTY, OHIO _______________________________, JUDGE IN THE MATTER OF __________________________________________, AN ADULT CASE NO. _______________________ NOTICE OF HEARING ON PETITON FOR TEMPORARY RESTRAINING ORDER TO PREVENT INTERFERENCE WITH THE PROVISION OF SERVICES [R.C. 5101.68] TO:__________________________________________________________________________ (Name of Person interfering with the provision of services) _____________________________________________________________________________________________ (Address) The above captioned Adult has consented to the provision of adult protective services pursuant to Chapter 5101. of the Revised Code. You hereby notified that a Petition for Temporary Restraining Order to Prevent Interference with the Provision of Services was filed with this Court pursuant to R.C. 5101.68. It is alleged in the Petition that you are interfering with the provision of protective services for the Adult, and that a temporary restraining order should be issued against you to prevent your interference. A copy of the Petition is attached hereto. The Petition for Temporary Restraining Order to Prevent Interference with the Provision of Services shall be heard in the ________________ County Probate Court, ______________, Ohio located at ________________________ on the _____ day of _____________, 20 _______at ______________ o’clock ______.M. You or any interested person is permitted to attend this hearing and give testimony or present other evidence as to why the petition for restraining order should or should not be granted. Witness my signature and the seal of the Court This _____ day of _____________, 20 _______. ______________________________________ Probate Judge By:___________________________________ Deputy Clerk FORM 23.7 – NOTICE OF HEARING ON PETITION FOR TEMPORARY RESTRAINING ORDER TO PREVENT INTERFERENCE WITH THE PROVISION OF SERVICES Eff. Date: January 1, 2010 American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. ______________________ The State of Ohio, _________________ 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 ________________________,___________ Received this notice 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 __________________________________________ _____________________________________________________________________________ _______________________________ FEES _______________________________ Service and return, 1st name, $ _____ _____ Additional names, at $ _____ _____Miles traveled, at $ _____ _____________________ ____________________________________ Sheriff ____________________________________ Deputy Sheriff/Process Server ____________________________________ Name $ _____ Total $ _____ _______________________________ ____________________________________ Title FORM 23.7 – NOTICE OF HEARING ON PETITION FOR TEMPORARY RESTRAINING ORDER TO PREVENT INTERFERENCE WITH THE PROVISION OF SERVICES Eff. Date: January 1, 2010 American LegalNet, Inc. www.FormsWorkFlow.com