Order Granting Petition For Release Of Identifying Information {19.4}

PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. McCOLLUM, JUDGE IN THE MATTER OF THE ADOPTION OF __________________________________ (Name after adoption) CASE NO. ___________________ ORDER GRANTING PETITION FOR RELEASE OF IDENTIFYING INFORMATION Upon request of the Petitioner for release of information concerning an adoption proceeding and a subsequent order to ________________________________________________ and the Department of (Agency) Health to perform the tasks required by R.C. 3107.41, the Court finds that the agency has reported that petitioner's biological mother father sibling(s) [check appropriate language] have/has filed an effective release which has not been withdrawn and the agency has provided the Court with a copy of the identifying information. The COURT HEREBY GRANTS the Petition in relation to said biological mother father sibling(s) [check appropriate language] and informs Petitioner of the adoption and that the adoption proceeding took place in Montgomery County Probate Court and hereby orders that ________________ ________________________________ release said identifying information to the Petitioner accordingly. (Agency) _________________________________________ Alice O. McCollum, Probate Judge M.C. FORM 19.4 ­ ORDER GRANTING PETITION FOR RELEASE OF IDENTIFYING INFORMATION American LegalNet, Inc. www.FormsWorkFlow.com