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​​Numerical Index of Approved Adoption Court Forms

 

  
  
  
Citation
Previous Versions
pca3016/17Petition for Adoption
MCL 710.24, MCL 710.26, MCL 710.45,
MCL 710.46, MCL 710.52, MCL 710.56, MCL 712B.9(1)
(2/15) version can be used until stock is depleted
pca301a6/17Petition for Direct Placement Adoption
MCL 710.24, MCL 710.46, MCL 710.56, MCL 712B.9(1)
(2/15) version can be used until stock is depleted
pca3026/17Supplemental Petition and Affidavit to Terminate Parental Rights (Stepparent Adoption)
MCL 710.26, MCL 710.51(6), MCL 712B.9(1), MCR 3.801
(2/15) Can be used until 6/30/2017
pca3032/15Notice of Hearing, Termination of Parental Rights
MCL 712B.9, MCR 3.801, MCR 3.802, MCR 3.803
(3/10) version can be used until stock is depleted
pca3046/17Order Terminating Parental Rights (Stepparent Adoption)
MCL 710.51, MCL 712B.1 et seq., 25 USC 1901 et seq., MCR 3.801, MCR 3.802
(2/15) Can be used until 6/30/2017
pca3052/15Release of Child by Parent
MCL 710.28, MCL 710.29, MCL 710.54, MCR 3.801,
(9/10) version can be used until 12/31/15
pca305a2/15Release of Child by Guardian
MCL 700.431(1)(c), MCL 710.28, MCL 710.29,
MCL 710.54, MCR 3.801
(09/07) version can be used until 12/31/15
pca305i9/17Release of Indian Child by Parent
MCL 710.28, MCL 710.29, MCL 710.54, MCL 712B.13,
MCL 712B.27, 25 USC 1913(a), MCR 3.801
Existing paper stock cannot be used.
pca30611/05Release of Child by Child Placing Agency
MCL 710.28, MCL 710.29, MCR 3.801
pca3072/15Consent to Adoption by Adoptee
MCL 710.43, MCR 3.801
(9/07) version can be used until 12/31/15
pca3082/15Consent to Adoption by Parent
MCL 710.22, MCL 710.43, MCL 710.44, MCL 710.54, 25 USC 1913(a), MCR 3.801
(9/10) version can be used until 12/31/15
pca308a2/15Consent to Adoption by Guardian
MCL 700.5215(e), MCL 710.22, MCL 710.43,
MCL 710.44, MCL 710.54, MCR 3.801
(9/07) version can be used until 12/31/15
pca308i9/17Consent by Parent to Adoption of Indian Child
MCL 710.43, MCL 710.44, MCL 710.54,
MCL 712B.13, MCL 712B.27, 25 USC 1913(a), MCR 3.801
Existing paper stock cannot be used.
pca3092/15Consent to Adoption by Agency/Court
MCL 710.43, MCL 710.44, MCR 3.801
(3/12) version can be used until depleted
pca3106/17Petition for Hearing to Identify Father and Determine or Terminate His Rights
MCL 710.22(d), MCL 710.36, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.803

(2/15) version can be used until stock is depleted
pca3116/17Notice of Hearing to Identify Father and Determine or Terminate His Rights
MCL 712B.9, MCL 712B.13(1)(b),
MCR 3.801, MCR 3.802, MCR 3.803
(2/15) version can be used until stock is depleted
pca3126/17Order Terminating Rights of Father without Release or Consent
MCL 710.36, MCL 712B.1 et seq., 25 USC 1901 et seq.
(2/15) version can be used until stock is depleted
pca3139/07Petition to Issue Notice of Intent to Release or Consent
MCL 710.33, MCL 710.34, MCR 3.801
pca3149/07Notice of Intent to Release or Consent
MCL 710.34, MCR 3.801, MCR 3.802
pca3152/15Declaration of Inability to Identify/Locate Father
MCL 710.22(d), MCL 710.36, MCL 710.37,
MCR 3.801, MCR 3.802(B)
(9/07) version can be used until depleted
pca3166/17Notice to Putative Father and Custody Statement
MCL 710.36, MCL 710.37, MCR 3.801
(2/15) version can be used until stock is depleted
pca3183/16Order Terminating Parental Rights/Rights of Person In Loco Parentis After Release or Consent
MCL 710.29(7), MCL 710.55(1), 25 USC 1901 et seq., MCL 712B.1 et seq.
(2/15) version can be used until stock is depleted
pca3196/17Order Placing Child (Stepparent Adoption)
MCL 710.51, MCL 710.52, 25 USC 1915(a)
(9/10) Can be used until 6/30/2017
pca3202/15Order Placing Child after Consent
MCL 710.51, MCL 710.52, MCL 712B.23
(2/13) version can be used until stock is depleted
pca32112/15Order of Adoption
MCL 710.56, MCL 710.60
(9/07) version can be used until 12/18/15
pca321b12/15Order of Adoption (alternative format suitable for framing)
MCL 710.56, MCL 710.60
(9/98) version can be used until 12/18/15
pca3222/15Order Committing Child to Agency/Department of Health and Human Services
MCL 710.29(8), MCL 712B.13, MCL 712B.23
(3/10) version can be used until stock is depleted
pca3232/15Advice of Rights after Order Terminating Parental Rights (Adoption Code)
MCL 710.27, MCL 710.29, MCL 710.64, MCL 710.65, MCL 710.68
(9/08) version can be used until 12/31/15
pca323i2/15Advice of Rights After Order Terminating Parental Rights to Indian Child (Adoption Code)
MCL 710.27, MCL 710.29, MCL 710.64, MCL 710.65, MCL 710.68, MCL 712B.13(3), (6), 25 USC 1913(c)
New form
pca3252/15Notice to Adopting Parents on Pending or Potential Appeal/Rehearing
MCL 710.41
(2/15) version can be used until stock is depleted
pca3269/07Order Authorizing Foster Care Funding After Release
MCL 710.29
pca3272/15Petition for Adoption Information and Order
MCL 710.67, MCL 710.68
(9/07) version can be used until stock is depleted
pca3286/17Certificate of Adoptive Information
25 CFR 23.140(a), 25 USC 1951
(3/16) version can be used until stock is depleted
pca3292/15Statement of Parent/Guardian Authorizing Temporary Placement of Child for Adoption
MCL 710.23b, MCL 710.23d
(9/07) version can be used until stock is depleted
pca3302/15Statement of Parent/Guardian Transferring Physical Custody of Child for Adoption
MCL 710.23d
(9/06) version can be used until stock is depleted
pca3312/15Statement of Child-Placing Agency Transferring Physical Custody of Child for Adoption
MCL 710.23d
(9/06) version can be used until stock is depleted
pca3322/15Statement of Prospective Adoptive Parent Transferring Physical Custody of Child for Adoption
MCL 710.23d
(9/07) version can be used until stock is depleted
pca332a2/15Statement of Nonresident Prospective Adoptive Parent Transferring Physical Custody of Child for Adoption
MCL 710.23d
(2/13) version can be used until stock is depleted
pca3332/15Follow-up Report after Temporary Placement of Child for Adoption
MCL 710.23d(3)
(9/06) version can be used until stock is depleted
pca3349/07Clerk's Report to Prosecuting Attorney
MCL 710.23d
pca3352/15Petition to Determine Custody of Child Temporarily Placed for Adoption
MCL 710.23d
(9/07) version can be used until stock is depleted
pca3369/07Order to Determine Custody of Child Temporarily Placed for Adoption
MCL 710.23e
pca3372/15Petition by Parent/Guardian for Return of Child and Ex Parte Order
MCL 710.23d, MCL 710.23e
(9/07) version can be used until stock is depleted
pca3382/15Statement to Accompany Release
MCL 710.29(6)
(9/07) version can be used until stock is depleted
pca3392/15Statement to Accompany Consent in Direct Placement
MCL 710.44(5)
(9/07) version can be used until stock is depleted
pca3406/17Statement of Identifying Information
MCL 710.24(7)
(9/11) version can be used until stock is depleted
pca3419/07Final Order Allowing Fees and Costs
MCL 710.54(10)
pca3422/15Petition and Order to Appoint Confidential Intermediary
MCL 710.68b
(9/07) version can be used until stock is depleted
pca3432/15Petition and Order for Approval of Confidential Intermediary Fee
MCL 710.68b
(9/07) version can be used until stock is depleted
pca3442/15Petition and Order Regarding Release of Information from Confidential Intermediary and Court
MCL 710.68b(6)
(9/09) version can be used until stock is depleted
pca3459/07Statement of Services Performed by Agency/Department of Human Services
MCL 710.54(7)
pca3466/17Statement of Services Performed by Attorney
MCL 710.54(7)
(9/07) version can be used until stock is depleted
pca3473/16Petitioner's Verified Accounting
MCL 710.54(7), MCR 3.803(A)
(2/15) version can be used until stock is depleted
pca347a2/15Supplement to Petitioner's Verified Accounting
MCL 710.54(7), MCR 3.803(A)
New form
pca3482/15Parent's or Guardian's Verified Accounting for Adoption Release or Direct Placement Consent
MCL 710.29(6), MCL 710.44(5)
(9/07) version can be used until stock is depleted
pca3492/15Petition for Rescission of Adoption and Order
MCL 710.66
(9/07) version can be used until stock is depleted
pca3506/17Petition and Order for Delayed Registration of Foreign Birth
MCL 333.2830
(2/15) version can be used until stock is depleted
pca3519/07Order Following Hearing on Review of Adoption Placement (IV-E Eligibility Compliance)
42 USC 671(a)(15)
pca3522/15Notice of Adoption Proceedings Concerning an Indian Child
25 USC 1912, MCL 712B.9,
MCL 712B.27, MCR 3.802(A)(3)
(7/11) version can be used until stock is depleted
pca3536/17Request for Confidentiality
25 USC 1951(a)
(3/10) version can be used until stock is completed
pca3542/15Out-of-Court Release of Child by Parent
MCL 710.29
New form
pca3552/15Out-of-Court Consent to Direct Placement Adoption by Parent
MCL 710.44
New form
pca3566/17Verified Declaration About Paternity (Out-of-Court Release or Consent)
MCL 710.36(6), MCL 710.37
New Form
pca356a6/17Addendum A to Verified Declaration About Paternity (Father's Name and Whereabouts Known)
MCL 710.39
New Form
pca356b6/17Addendum B to Verified Declaration About Paternity (Father's Name Unknown, but Whereabouts Unknown)
MCL 710.37(2)(b)
New Form
pca356c6/17Addendum C to Verified Declaration About Paternity (Father's Name and Whereabouts Unknown)
MCL 710.37(2)(a)
New Form