Fill and Sign the Oh Grandparents Rights Form

IN THE COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION ________________ COUNTY, OHIO _____________________________ Petitioner (Name of Petitioner) V. CAUSE NO. _________________ ____________________________ Respondent (Name of Respondent) PETITION FOR GRANDPARENT VISITATION PRIVILEGES C OMES NOW the Petitioner, ____________________________ (Name of Petitioner) , pursuant to O.R.C. § 3109.11 , and respectfully requests the Court to grant me Grandparent Visitation Privileges. The grounds for my request are as follows: 1. Petitioner is an adult resident citizen of _______________________________________ __________________ (city, county, state) . 2. Petitioner is the (e.g., Grandfather) __________________ of _____________________ (Name of Grandchild) , the minor child (the Child ) for whom visitation is requested. 3. The only surviving parent of the Child is the Respondent who is an adult resident citizen of, and resides at, ________________________________________________________ __________________ (street address, city, county, state, zip code) . 4. The Father of the Child , who was also Petitioner’s son, was _____________________ (Name) who resided at _________________________________________________________ ___________________ (street address, city, county, state, zip code) , and departed this life on the _____ day of ________________, 20____. _____________________________ (Name of Father) and the Respondent , the Mother of the Child, were never married. W HEREFORE , Petitioner requests that the Court order the following: 1. Reasonable permanent visitation privileges to the Petitioner ; 2. Reasonable temporary visitation privileges to the Petitioner until the final decision is made; and 3. Such other and further relief as the Court deems appropriate. Signature of Petitioner ___________________________ Print Name ___________________________ Print Address ___________________________ Print City/State/Zip ___________________________ Print Telephone No. S TATE OF OHIO ) ) SS . C OUNTY OF ) I, ________________________________ (Name of Petitioner) , the Petitioner , being first duly sworn upon my oath, depose and state that I am the Petitioner in the above-entitled cause. I have read the attached Petition for Grandparent Visitation Privileges. I state that the contents thereof are true and correct as therein state. (Signature of Petitioner) Sworn to before me this _ day of , 20____. My Commission expires: Notary Public Remember: It is your obligation to promptly mail or serve a copy to the other party.