Ohio Probate Form - Petition To Recognize Foreign Adoption Page 2
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2[Reverse of Form 19.2]
CASE NO.______________
Attached is a certified copy of the Foreign Decree or Certificate of Adoption which has been verified and approved
by the Immigration and Naturalization Service of the United States, and if not in English, also attached is a
translation certified as to its accuracy by the translator.
Attached is a fully completed Ohio Department of Health, Division of Vital Statistics, Certificate of Adoption.
The Petitioner(s) state that giving effect to the Foreign Decree or Certificate of Adoption would not violate the public
policy of the State of Ohio and respectfully pray for the following Order(s):
An Order that the child's name shall be changed to:
________________________________________________________________________________
An order to the Ohio Department of Health to issue a new birth record for the adopted person under R.C.
3705.12(A)(1)
Other __________________________________________________________________________
______________________________________
____________________________________
Attorney for Petitioner
Petitioner
______________________________________
____________________________________
Typed or Printed Name
Typed or Printed Name
______________________________________
____________________________________
Street Address
Petitioner
______________________________________
____________________________________
City
State
Zip Code
Typed or Printed Name
______________________________________
____________________________________
Telephone Number (include area code)
Street Address
Attorney Registration No. __________________
____________________________________
City
State
Zip Code
____________________________________
Telephone Number (include area code)
Print Form
FORM 19.2 – PETITION TO RECOGNIZE FOREIGN ADOPTION
PAGE 2
Effective Date: March 1, 2014
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