COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

HAMILTON COUNTY, OHIO

PARENTING COORDINATOR ANNUAL COMPLIANCE STATEMENT

Name:

Attorney Number:

For Compliance Year:

Attached to this statement is proof of attendance of at least six hours of continuing education related to children, families, mediation or diversity that the Supreme Court of Ohio has approved.

By signature below, I certify that I am unaware of any circumstances that would disqualify me from serving as a parenting coordinator in any court. I also certify that I have provided an updated resume to the Dispute Resolution Department with any substantive changes or any changes to name, address, telephone number and electronic mail address.

I understand that the Compliance Statement is due to the Dispute Resolution Department before the first of the year.

______________________________

Signature

______________________________

Date