IN THE COURT OF COMMON PLEAS

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IN THE COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION WAYNE COUNTY, OHIO Name CASE NO. Address JUDGE City, State, Zip Phone MAGISTRATE Petitioner/Plaintiff vs. Name NOTICE OF INTENT TO RELOCATE Address O.R.C. 3109.051(G) City, State, Zip Phone Petitioner/Defendant/Respondent 1. I, ___________________________, a Residential Parent in the above-captioned case, hereby give notice of my intent to relocate. The following children will be moving with me: a. (name) (DOB) b. (name) (DOB) c. (name) (DOB) d. (name) (DOB) 2. I plan to move to (street, city, state, zip) on (date) 3. I have mailed a copy of this notice to the other parent. ______________________________________ Signature ______________________________________ Date

NOTICE TO PARENT YOU HAVE THE RIGHT TO FILE A MOTION AND REQUEST A HEARING FOR THE COURT TO DETERMINE WHETHER IT IS IN THE BEST INTEREST OF THE CHILD(REN) TO REVISE THE PARENTING TIME SCHED ULE. IF YOU WANT THIS COURT TO SET THIS MATTER FOR HEARING ON PARENTING TIME ISSUES, YOU MAY FILE A MOTION TO MODIFY THE PARENTING TIME SCHEDULE. For a sample motion, please refer to our website at: http://courtsweb.waynecountycourthouse.com * It is recommended that an attorney review and file any pleadings for you. There are many procedures with which they can help you to achieve a satisfactory resolution of your problem.