COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF COUNTY, OHIOERIEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF THE ADOPTION OF(Name after adoption)CASE NO.CONSENT TO ADOPTION [R.C. 3107.06, 3107.08 & 3107.081]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .[R.C. 3107.06, 3107.08 & 3107.081]The undersignedTHE PEOPLE OF THE STATE OF NEW YORK TOMother [Check one of the following seven capacities by which your consent is given] Father Putative father who has registered under R.C. 3107.062 (for a minor born on or after January 1, 1997) R.C. 3107.062GREETINGS:Putative father (for a minor born before January 1, 1997) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableAgency having permanent custody ,Minor, who is more than twelve years of age (this consent must be executed in the presence of the Court) located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomOtherhereby waives notice of the hearing on the Petition For Adoption to be filed in the Court, and consents to the adoption ofYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.(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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Sworn to before me and signed in my presence this.day ofAttorney(s) forPerson authorized pursuant to R.C. Chapter 3107 to take this acknowledgementOffice and P.O. AddressTitleTelephone No.: Facsimile No.: E-Mail Address:3/9718.3 CONSENT TO ADOPTIONMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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