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     
	(CHILD OR CHILDREN)	Case No (Leave Blank)	
       (Please print legibly or type on official form)
			    FF # (Leave Blank)
			
In the Matter of								    Judge (Leave Blank)		 

(INSERT CHILD’S NAME) 

alleged unruly child.

The undersigned, after being duly sworn, according to law, says that he/she has knowledge of a certain child to wit: (CHILDS NAME) age ____years, D.O.B. __________ who appears to be an unruly child in that

During a period of time between (DATES: MM/DD/YYYY), (JUVENILE'S NAME) in Lorain County, Ohio was an habitual truant, as defined in Section 2151.011(B)(18) of the Revised Code, to wit:(INSERT # OF HOURS HERE) total unexcused hours of absences (insert one of the following: consecutively, in a school month or in a school year), in violation of Section 2151.022(B) of the Ohio Revised Code.
(Habitual Truant)

Complainant further says:

That said child now resides at (ADDRESS)
That the names and addresses of the parents or custodian of said child is (PARENTS NAME) residing 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)