Form DHS-1925 "Request by Adult Adoptee for Identifying Information" - Michigan

What Is Form DHS-1925?

This is a legal form that was released by the Michigan Department of Health and Human Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2005;
  • The latest edition provided by the Michigan Department of Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DHS-1925 by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.

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Download Form DHS-1925 "Request by Adult Adoptee for Identifying Information" - Michigan

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REQUEST BY ADULT ADOPTEE FOR IDENTIFYING INFORMATION
State of Michigan
Department of Human Services
I hereby request, from my adoption records, my name before placement in adoption, the names of
my biological parents, including their current names, if available, most recent address or addresses
of biological parents, and names of biological siblings at the time of termination.
CURRENT INFORMATION
Current Name (Last, First, Middle)
Birth Date
Month
Day
Year
Current Address (Street Number and Name)
Apartment Number
City
State
Zip Code
Telephone Number
A/C (
)
ADOPTION INFORMATION
Adoptive Name (Last, First, Middle)
Name Before Adoption (If Known)
Adoptive Mother’s Name
Adoptive Father’s Name
Birth Mother’s Name
Birth Father’s Name
Name of Probate Court
Name of Placing Agency
Also, please send me non-identifying information from my file.
Additional Comments
Adult Adoptee’s Signature
Date
DISTRIBUTION:
Original - Adoption Agency or Court that
Finalized the Adoption
Copy -
Keep for Your Records
Department of Human Services (DHS) will not discriminate against any
AUTHORITY: MCLA 710.68.
individual or group because of race, sex, religion, age, national origin, color,
COMPLETION: Voluntary.
height, weight, marital status, political beliefs or disability. If you need help
with reading, writing, hearing, etc., under the Americans with Disabilities Act,
PENALTY: None.
you are invited to make your needs known to a DHS office in your area.
DHS-1925 (Rev. 8-05) Previous edition may be used. MS Word
REQUEST BY ADULT ADOPTEE FOR IDENTIFYING INFORMATION
State of Michigan
Department of Human Services
I hereby request, from my adoption records, my name before placement in adoption, the names of
my biological parents, including their current names, if available, most recent address or addresses
of biological parents, and names of biological siblings at the time of termination.
CURRENT INFORMATION
Current Name (Last, First, Middle)
Birth Date
Month
Day
Year
Current Address (Street Number and Name)
Apartment Number
City
State
Zip Code
Telephone Number
A/C (
)
ADOPTION INFORMATION
Adoptive Name (Last, First, Middle)
Name Before Adoption (If Known)
Adoptive Mother’s Name
Adoptive Father’s Name
Birth Mother’s Name
Birth Father’s Name
Name of Probate Court
Name of Placing Agency
Also, please send me non-identifying information from my file.
Additional Comments
Adult Adoptee’s Signature
Date
DISTRIBUTION:
Original - Adoption Agency or Court that
Finalized the Adoption
Copy -
Keep for Your Records
Department of Human Services (DHS) will not discriminate against any
AUTHORITY: MCLA 710.68.
individual or group because of race, sex, religion, age, national origin, color,
COMPLETION: Voluntary.
height, weight, marital status, political beliefs or disability. If you need help
with reading, writing, hearing, etc., under the Americans with Disabilities Act,
PENALTY: None.
you are invited to make your needs known to a DHS office in your area.
DHS-1925 (Rev. 8-05) Previous edition may be used. MS Word