Complaint Form
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2COURT OF COMMON PLEAS FRANKLIN COUNTY, OHIO
DIVISION OF DOMESTIC RELATIONS
JUVENILE BRANCH
COMPLAINT
STATE OF OHIO
AFFADAVIT NO.____________________________________
FRANKLIN COUNTY ss:
________________________________________________
____________________________________________
Mother, guardian or custodian
________________________________________________
____________________________________________
Address
SS#_____________________________________________
____________________________________________
Father, guardian or custodian
DATE OF BIRTH_________________________________
____________________________________________
Address
The undersigned being first duly cautioned and sworn, deposes and says that ________________________________________
____________________________, being a minor under the age of 18 years (to wit:_________ years), at the County of
Franklin, and State of Ohio, (OFFENSE #1) is *______________________ , did on or about the ____________ day of
____________________ , 20_____ , commit the offense of, _______________________________________________
in violation of Section No. _______________________ of ___________ a _______________________________ of the
(Misdemeanor/Felony)
__________ degree, in that:
Further: (OFFENSE #2) is *______________________ , did on or about the ____________ day of _________________
20_____ , commit the offense of, ____________________________________________________ in violation of Section
No. ____________________ of __________ a _____________________________ of the _____________ degree, in that:
(Misdemeanor/Felony)
*unruly or delinquent
Page 1 of 2
(eJU5302 6/2014)
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