Sign In
Bookmark and Share

Index of SCAO-Approved Forms for Use in Adoptions

This set of forms is for use in adoption proceedings. The forms must be filed in the family division of the circuit court.

 

  
  
  
Citation
Previous Versions
Advice of Rights after Order Terminating Parental Rights (Adoption Code)pca3232/15
MCL 710.27, MCL 710.29, MCL 710.64, MCL 710.65, MCL 710.68
(9/08) previous approved form cannot be used after 12/31/15
Advice of Rights After Order Terminating Parental Rights to Indian Child (Adoption Code)pca323i2/15
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
Certificate of Adoptive Informationpca3282/15
25 USC 1951
(9/97) previous approved form can be used until stock is depleted
Clerk's Report to Prosecuting Attorneypca3349/07
MCL 710.23d
Consent by Parent to Adoption of Indian Childpca308i2/15
MCL 710.43, MCL 710.44, MCL 710.54,
MCL 712B.13, MCL 712B.27, 25 USC 1913(a), MCR 3.801
New form
Consent to Adoption by Adopteepca3072/15
MCL 710.43, MCR 3.801
(9/07) previous approved form cannot be used after 12/31/15
Consent to Adoption by Agency/Courtpca3092/15
MCL 710.43, MCL 710.44, MCR 3.801
(3/12) previous approved form can be used until depleted
Consent to Adoption by Guardianpca308a2/15
MCL 700.5215(e), MCL 710.22, MCL 710.43,
MCL 710.44, MCL 710.54, MCR 3.801
(9/07) previous approved form cannot be used after 12/31/15
Consent to Adoption by Parentpca3082/15
MCL 710.22, MCL 710.43, MCL 710.44, MCL 710.54, 25 USC 1913(a), MCR 3.801
(9/10) previous approved form cannot be used after 12/31/15
Declaration of Inability to Identify/Locate Fatherpca3152/15
MCL 710.22(d), MCL 710.36, MCL 710.37,
MCR 3.801, MCR 3.802(B)
(9/07) previous approved form can be used until depleted
Final Order Allowing Fees and Costspca3419/07
MCL 710.54(10)
Followup Report after Temporary Placement of Child for Adoptionpca3332/15
MCL 710.23d(3)
(9/06) previous approved form can be used until stock is depleted
Motion and Order for Delayed Registration of Foreign Birthpca3502/15
MCL 333.2830
(9/07) previous approved form can be used until stock is depleted
Notice of Adoption Proceedings Concerning an Indian Childpca3522/15
25 USC 1912, MCL 712B.9,
MCL 712B.27, MCR 3.802(A)(3)
(7/11) previous approved form can be used until stock is depleted
Notice of Hearing to Identify Father and Determine or Terminate His Rightspca3112/15
MCL 712B.9, MCL 712B.13(1)(b),
MCR 3.801, MCR 3.802, MCR 3.803
(3/10) previous approved form can be used until stock is depleted
Notice of Hearing, Termination of Parental Rightspca3032/15
MCR 3.801, MCR 3.802, MCR 3.803
(3/10) previous approved form which can be used until stock is depleted
Notice of Intent to Release or Consentpca3149/07
MCL 710.34, MCR 3.801, MCR 3.802
Notice to Adopting Parents on Pending or Potential Appeal/Rehearingpca3253/15
MCL 710.41
(2/15) previous approved form can be used until stock is depleted
Notice to Putative Father and Custody Statementpca3162/15
MCL 710.36, MCL 710.37, MCR 3.801
(9/06) previous approved form can be used until depleted
Order Authorizing Foster Care Fundingpca3269/07
MCL 710.29
Order Committing to Agency/DHHSpca3222/15
MCL 710.29(7)
(3/10) previous approved form which can be used until stock is depleted
Order Following Hearing on Review of Adoption Placement (IV-E Eligibility Compliance)pca3519/07
42 USC 671(a)(15)
Order of Adoptionpca3219/07
MCL 710.56, MCL 710.60
Order of Adoption (alternative format suitable for framing)pca321a9/07
Order of Adoption (alternative format suitable for framing)pca321b9/98
Order Placing Child (Stepparent Adoption)pca3199/10
25 USC 1915(a), MCL 710.51, MCL 710.52
(3/10) previous approved form which can be used until stock is depleted
Order Placing Child after Consentpca3202/15
MCL 710.51, MCL 710.52, MCL 712B.23
(2/13) previous approved form which can be used until stock is depleted
Order Terminating Parental Rights/ Rights of Person In Loco Parentis after Release or Consentpca3182/15
MCL 710.29(7), MCL 710.51(1), MCL 710.55(1),
25 USC 1901 et seq.,
MCL 712B.1 et seq.,
(3/10) previous approved form which can be used until stock is depleted
Order Terminating Rights of Father without Release or Consentpca3122/15
MCL 710.36, 25 USC 1901 et seq.,
MCL 712B.1 et seq.
(5/10) previous approved form which can be used until stock
Order Terminating Rights of Noncustodial Parentpca3042/15
MCL 710.51, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.802, In re AJR, 496 Mich 346, 852 NW2d 760 (2014)
(7/13) previous approved form which can be used until stock is depleted
Order to Determine Custody of Child Temporarily Placed for Adoptionpca3369/07
MCL 710.23e
Out-of-Court Consent to Direct Placement Adoption by Parentpca3552/15
MCL 710.44
New form
Out-of-Court Release of Child by Parentpca3542/15
MCL 710.29
New form
Parent's or Guardian's Verified Accounting for Adoption Release or Direct Placement Adoptionpca3482/15
MCL 710.29(5), MCL 710.44(5)
(9/07) previous approved form can be used until stock is depleted
Petition and Order for Approval of Confidential Intermediary Feepca3432/15
MCL 710.68b
(9/07) previous approved form can be used until stock is depleted
Petition and Order for Release of Information from Confidential Intermediary and Courtpca3442/15
MCL 710.68b(6)
(9/09) previous approved form can be used until stock is depleted
Petition and Order to Appoint Confidential Intermediarypca3422/15
MCL 710.68b
(9/07) previous approved form can be used until stock is depleted
Petition by Parent/Guardian for Return of Child and Ex Parte Orderpca3372/15
MCL 710.23d, MCL 710.23e
(9/07) previous approved form can be used until stock is depleted
Petition for Adoptionpca3012/15
MCL 710.24, MCL 710.26, MCL 710.45,
MCL 710.46, MCL 710.52, MCL 710.56, MCL 712B.9(1)
(2/13) previous approved form which can be used until stock is depleted
Petition for Adoption Information and Orderpca3272/15
MCL 710.67, MCL 710.68
(9/07) previous approved form can be used until stock is depleted
Petition for Direct Placement Adoptionpca301a2/15
MCL 710.24, MCL 710.46, MCL 710.56, MCL 712B.9(1)
(6/13) previous approved form which can be used until stock is depleted
Petition for Hearing to Identify Father and Determine or Terminate His Rightspca3102/15
MCL 710.22(d), MCL 710.36, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.803

(3/10) previous approved form which can be used until stock is depleted
Petition for Rescission of Adoption and Orderpca3492/15
MCL 710.66
(9/07) previous approved form can be used until stock is depleted
Petition to Determine Custody of Child Temporarily Placed for Adoptionpca3352/15
MCL 710.23d
(9/07) previous approved form can be used until stock is depleted
Petition to Issue Notice of Intent to Release or Consentpca3139/07
MCL 710.33, MCL 710.34, MCR 3.801
Petitioner's Verified Accountingpca3472/15
MCL 710.54(7), MCR 3.803(A)
(9/11) previous approved form which can be used until stock is  depleted
Release of Child by Child Placing Agencypca30611/05
MCL 710.28, MCL 710.29, MCR 3.801
Release of Child by Guardianpca305a2/15
MCL 700.431(1)(c), MCL 710.28, MCL 710.29,
MCL 710.54, MCR 3.801
(09/07) previous approved form cannot be used after 12/31/15
Release of Child by Parentpca3052/15
MCL 710.28, MCL 710.29, MCL 710.54, MCR 3.801,
(9/10) previous approved form may not be used after 12/31/15
Release of Indian Child by Parentpca305i2/15
MCL 710.28, MCL 710.29, MCL 710.54, MCL 712B.13,
MCL 712B.27, 25 USC 1913(a), MCR 3.801
New form
Request for Confidentialitypca3533/10
25 USC 1951(c)
Statement of Child Placing Agency Transferring Physical Custody of Child for Adoptionpca3312/15
MCL 710.23d
(9/06) previous approved form can be used until stock is depleted
Statement of Identifying Informationpca3409/11
MCL 710.24(5)
(9/07) previous approved form which can be used until stock is depleted
Statement of Nonresident Prospective Adoptive Parent Transferring Physical Custody of Child for Adoptionpca332a2/15
MCL 710.23d
(2/13) previous approved form which can be used until stock is depleted
Statement of Parent/Guardian Authorizing Temporary Placement of Child for Adoptionpca3292/15
MCL 710.23b, MCL 710.23d
(9/07) previous approved version of the form can be used until stock is depleted
Statement of Parent/Guardian Transferring Physical Custody of Child for Adoptionpca3302/15
MCL 710.23d
(9/06) previous approved version of the form can be used until stock is depleted
Statement of Prospective Adoptive Parent Transferring Physical Custody of Child for Adoptionpca3322/15
MCL 710.23d
(9/07) previous approved form can be used until stock is depleted
Statement of Services Performed by Agency/Department of Human Servicespca3459/07
MCL 710.54(7)
Statement of Services Performed by Attorneypca3469/07
MCL 710.54(7)
Statement to Accompany Consent in Direct Placementpca3392/15
MCL 710.44(5)
(9/07) previous approved form can be used until stock is depleted
Statement to Accompany Releasepca3382/15
MCL 710.29(5)
(9/07) previous approved form can be used until stock is depleted
Supplement to Petitioner's Verified Accountingpca347a2/15
MCL 710.54(7), MCR 3.803(A)
New form
Supplemental Petition and Affidavit to Terminate Parental Rights of Noncustodial Parentpca3022/15
MCL 710.26, MCL 710.51(6), MCR 3.801, In re AJR, 496 Mich 346, 852 NW2d 760 (2014)
(3/10) previous approved form which can be used until stock is depleted