Form PCA 310 Petition for Hearing to Identify Father and Determine or Terminate His Rights - Michigan

Form PCA310 or the "Petition For Hearing To Identify Father And Determine Or Terminate His Rights" is a form issued by the Michigan Circuit Court.

Download a PDF version of the Form PCA310 down below or find it on the Michigan Circuit Court Forms website.

ADVERTISEMENT
Approved, SCAO
JIS CODE: PHT
STATE OF MICHIGAN
FILE NO.
PETITION FOR HEARING TO IDENTIFY
JUDICIAL CIRCUIT - FAMILY DIVISION
FATHER AND DETERMINE OR
COUNTY
TERMINATE HIS RIGHTS
In the matter of
, adoptee
Full name of child
1. I am the mother of the adoptee named above who was born out of wedlock on
at
Date
. The adoptee resides at
City, county, and state
.
Address
City
State
Zip
2. An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor
has been previously filed in
Court, Case Number
, was
assigned to Judge
, and
remains
is no longer
pending.
3. I plan to sign a
release
consent giving up my parental rights to the child.
4. I have joined with my spouse in a petition for adoption.
5. The child is an Indian child as defined in MCR 3.002(12). The identity of the tribe is
.
Name of tribe, if known
6. The putative father of my child is:
Name (type or print)
Birthdate (if unknown, state if over 18 years old)
Address
City, state, zip
7. For part or all of the time from conception to the date the child was born, I was married to
Name (type or print)
whose last-known address is
. He is not the father of the child.
(SEE SECOND PAGE)
Do not write below this line - For court use only
MCL 710.22(d), MCL 710.36, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.803
PETITION FOR HEARING TO IDENTIFY FATHER AND DETERMINE OR TERMINATE HIS RIGHTS
PCA 310 (6/17)
Approved, SCAO
JIS CODE: PHT
STATE OF MICHIGAN
FILE NO.
PETITION FOR HEARING TO IDENTIFY
JUDICIAL CIRCUIT - FAMILY DIVISION
FATHER AND DETERMINE OR
COUNTY
TERMINATE HIS RIGHTS
In the matter of
, adoptee
Full name of child
1. I am the mother of the adoptee named above who was born out of wedlock on
at
Date
. The adoptee resides at
City, county, and state
.
Address
City
State
Zip
2. An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor
has been previously filed in
Court, Case Number
, was
assigned to Judge
, and
remains
is no longer
pending.
3. I plan to sign a
release
consent giving up my parental rights to the child.
4. I have joined with my spouse in a petition for adoption.
5. The child is an Indian child as defined in MCR 3.002(12). The identity of the tribe is
.
Name of tribe, if known
6. The putative father of my child is:
Name (type or print)
Birthdate (if unknown, state if over 18 years old)
Address
City, state, zip
7. For part or all of the time from conception to the date the child was born, I was married to
Name (type or print)
whose last-known address is
. He is not the father of the child.
(SEE SECOND PAGE)
Do not write below this line - For court use only
MCL 710.22(d), MCL 710.36, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.803
PETITION FOR HEARING TO IDENTIFY FATHER AND DETERMINE OR TERMINATE HIS RIGHTS
PCA 310 (6/17)
Petition for Hearing to Identify Father and Determine/Terminate His Rights (6/17) Page
of
File No.
8. I request that the court hold a hearing to determine the identity of the father of my child and to determine or terminate his
parental rights.
Date
Attorney signature
Signature of petitioner
Attorney name (type or print)
Bar no.
Name (type or print)
Address
Address
City, state, zip
Telephone no.
City, state, zip
Telephone no.
Agency Contact Information:
Name of agency representative (type or print)
Address
Agency name
City, state, zip
Telephone no.
E-mail
CERTIFICATION BY PARENT/GUARDIAN OF UNEMANCIPATED MINOR PARENT
I certify that I am the
parent
legal guardian
of
,
Name of parent of child
who is an unemancipated minor parent of the child. I have reviewed this petition and agree with it.
Date
Signature of parent/guardian
Signature of witness
Name of parent/guardian (print)
Name of witness (print)
Address
City, state, and zip

Download Form PCA 310 Petition for Hearing to Identify Father and Determine or Terminate His Rights - Michigan

886 times
Rate
4.7(4.7 / 5) 62 votes
ADVERTISEMENT
Page of 2