INSTRUCTION SHEET
(To be used as a guide in filling out the official complaint)				       
In the Court of Common Pleas, Juvenile Division Lorain County, Ohio

COMPLAINT    
(Please print legibly or type on the official form)
		Case No (Leave Blank)	
		
		Judge  (Leave Bank)		
State of Ohio
	
	v			    

(NAME OF ADULT DEFENDANT)
Defendant  (DOB)

	The undersigned, after being duly sworn, according to law, says that he/she has knowledge that

During a period of time between (DATES: MM/DD/YYYY) (NAME) in Lorain County, Ohio, being the parent, guardian, or other person having care of (CHILD’S NAME), a child of compulsory school age, did violate any provision of Section 3321.01, 3321.03, 3321.04, 3321.07 or 3321.10, 3321.19, 3321.20 or 3331.14 of the Ohio Revised Code, to wit: (CHILD’S NAME) has a total of  (list #) hours of unexcused absences (in a school year, in a school month or consecutively) in violation of Section 3321.38(A) of the Ohio Revised Code, an Unclassified Misdemeanor.
(Failure to Send Child to School - an Unclassified Misdemeanor)

Complainant further says:
That (DEFENDANT’S NAME) now resides at (ADDRESS).
				_______________________________________
				Sign Name

				______________________________________________
			                         Print Name (please print legibly or type)	
			 	 	(Complainant)

				______________________________________________
				(Complainant’s Address)                      

				Sworn to before me and signed in my presence, this
			___________day of________________________, 20__
													By____________________________________________
					(Notary Public)