Objection to Change in Placement, Electronic Submission; Filed Pursuant to O.C.G.A. § 15-11-215 Name of Child or Children: * Name of Child or Children: First First Last Last Name of Person Filing Objection to Placement Change: * Name of Person Filing Objection to Placement Change: First First Last Last Relationship to Child(ren): Child age 14 or overParentLegal CustodianLegal GuardianGrandparentAdult SiblingOther Brief Summary of Reason for Objection: * File Number (optional): Email Address of Person Filing Objection: Phone Number of Person Filing Objection (optional) ELECTRONIC SIGNATURE AGREEMENT (Objection to Change in Placement): Electronic Signature Agreement By selecting the “I Accept” button, you are signing this Application electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Application. I Accept Electronic Signature (Type Your Name): signature keyboard Clear Date Submitted If you are human, leave this field blank. Submit Δ