When a resident of a veterans’ home becomes dangerous to the community due to a mental illness, the superintendent of the Ohio veterans’ homes shall file with the probate judge of the county in which the home is located substantially the following affidavit:

“The State of Ohio, __________ county, ss. ___________, superintendent of the Ohio veterans’ homes, being duly sworn, says that the superintendent believes that ____________, a resident of the veterans’ home located in __________ county, has a mental illness; that, in consequence of the resident’s mental illness, the resident’s being at large is dangerous to the community, and that the resident was received into the home from ____________ county, on the ______ day of _________, _____

____________________”