COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

HAMILTON COUNTY, OHIO

Petitioner
-and-
Petitioner

Enter:
Date:
Case No.
File No.
CSEA No.
Judge
WAIVER OF REPRESENTATION

, does hereby acknowledge and represent that they are not

Petitioner

represented by counsel in this proceeding. They further acknowledge that attorney for , has at all times represented and pursued the interest of their client; that said attorney does not represent the undersigned; that the undersigned was given full opportunity to evaluate their need for legal representation and was advised to obtain, if so desired, their own counsel. The undersigned realizes that this document acknowledges their consent to the attorney’s representation of and constitutes and acknowledges their waiver of right to counsel in this proceeding.

Petitioner