Consent To Adoption printable pdf download

Consent To Adoption

PROBATE COURT OF _______________ COUNTY, OHIO

IN THE MATTER OF THE ADOPTION OF _________________________________________

(Name after adoption)

CASE NO. ___________

CONSENT TO ADOPTION

[R.C. 3107.06, 3107.08 & 3107.081]

The undersigned _____________________________________________________________

[check one of the following seven capacities by which your consent is given]

□

Mother

□

Father

□

Parent

□

Putative father who has registered under R.C. 3107.062

□

Agency having permanent custody

□

Minor, who is more than twelve years of age (this consent must be executed

in the presence of the Court)

□

Other________________________________________________________

hereby waives notice of the hearing on the Petition For Adoption to be filed in the court, and

consents to the adoption of ___________________________________________________

(Name before adoption)

as proposed in the petition.

The undersigned further states that this consent is voluntarily executed irrespective of

disclosure of the name or other identification of the prospective adopting parents.

________________________________

Sworn to before me and signed in my presence this _______ day of _____________, 20_____

________________________________

Person authorized pursuant to R.C.

Chapter 3107 to take this

acknowledgement

________________________________

Title

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FORM 18.3 - CONSENT TO ADOPTION

Amended: March 15, 2016

Discard all previous versions of this form

Consent To Adoption