Form CCFD20 "Ex Parte Petition Regarding Voluntary Foster Care Agreement" - Michigan

Form CCFD20 or the "Ex Parte Petition Regarding Voluntary Foster Care Agreement" is a form issued by the Michigan Circuit Court.

Download a PDF version of the Form CCFD20 down below or find it on the Michigan Circuit Court Forms website.

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Download Form CCFD20 "Ex Parte Petition Regarding Voluntary Foster Care Agreement" - Michigan

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Approved, SCAO
JIS CODE: PVF
FILE NO.
STATE OF MICHIGAN
EX PARTE PETITION
JUDICIAL CIRCUIT - FAMILY DIVISION
REGARDING VOLUNTARY
COUNTY
FOSTER CARE AGREEMENT
In the matter of
Name of youth
DOB
Race
Gender
Current address
1. On
, the Department of Human Services and the youth named above signed a voluntary
Date
foster care agreement in compliance with MCL 400.651 to extend foster care services to the youth. A report prepared pursuant
to MCL 400.655, which includes a copy of the voluntary foster care agreement, is attached.
2. The name(s), date(s) of birth, and residence address(es) of the youth's parent(s) or legal custodian is/are:
(Complete only if parental
rights have not been terminated. Otherwise, enter "parental rights have been terminated.")
3. The name(s) and address of the youth's foster parent(s), if any, is/are:
4. The youth has been notified of the right to request a hearing regarding continuing foster care.
5. Jurisdiction of the
court over the youth, case number
,
was terminated on
.
Date
6. Other:
I REQUEST that the court determine whether continuing in voluntary foster care is in the youth's best interests.
I declare that the statements in this petition are true to the best of my information, knowledge, and belief.
Date
Signature of petitioner
Name (type or print)
Address
Telephone no.
City, state, zip
Do not write below this line - For court use only
EX PARTE PETITION REGARDING VOLUNTARY FOSTER CARE AGREEMENT
MCL 400.655, MCR 3.616
CCFD 20 (3/12)
Approved, SCAO
JIS CODE: PVF
FILE NO.
STATE OF MICHIGAN
EX PARTE PETITION
JUDICIAL CIRCUIT - FAMILY DIVISION
REGARDING VOLUNTARY
COUNTY
FOSTER CARE AGREEMENT
In the matter of
Name of youth
DOB
Race
Gender
Current address
1. On
, the Department of Human Services and the youth named above signed a voluntary
Date
foster care agreement in compliance with MCL 400.651 to extend foster care services to the youth. A report prepared pursuant
to MCL 400.655, which includes a copy of the voluntary foster care agreement, is attached.
2. The name(s), date(s) of birth, and residence address(es) of the youth's parent(s) or legal custodian is/are:
(Complete only if parental
rights have not been terminated. Otherwise, enter "parental rights have been terminated.")
3. The name(s) and address of the youth's foster parent(s), if any, is/are:
4. The youth has been notified of the right to request a hearing regarding continuing foster care.
5. Jurisdiction of the
court over the youth, case number
,
was terminated on
.
Date
6. Other:
I REQUEST that the court determine whether continuing in voluntary foster care is in the youth's best interests.
I declare that the statements in this petition are true to the best of my information, knowledge, and belief.
Date
Signature of petitioner
Name (type or print)
Address
Telephone no.
City, state, zip
Do not write below this line - For court use only
EX PARTE PETITION REGARDING VOLUNTARY FOSTER CARE AGREEMENT
MCL 400.655, MCR 3.616
CCFD 20 (3/12)
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