Michigan > Local County > Oakland > Family Division
Followup Report After Temporary Placement Of Child For Adoption PCA-333 - Michigan
| Followup Report After Temporary Placement Of Child For Adoption Form. This is a Michigan form and can be used in Family Division Oakland Local County . |
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Approved, SCAO STATE OF MICHIGAN 6th JUDICIAL CIRCUIT - FAMILY DIVISION Oakland COUNTY FILE NO. FOLLOWUP REPORT AFTER TEMPORARY PLACEMENT OF CHILD FOR ADOPTION In the matter of Full name of child DOB: NOTE: This report is to be completed within 30 days after the transfer of physical custody of the child. This report is in addition to the report included in the statement transferring custody (either Form PCA 330 or PCA 331). 1. I am the adoption attorney the above named child. 2. On Date representative of the child placing agency that assisted in the temporary placement of , for the purpose of adoption, physical custody of the child was transferred to the who reside Name(s) of prospective parent(s) prospective adoptive parent(s) in this county at Street address City Name(s) of parent(s) . Zip 3. The temporary placement was made by . Street address City State Zip 4. Since the transfer of physical custody, the following has occurred: a. a petition for adoption was filed by the prospective adoptive parents in this county on b. no petition for adoption was filed and physical custody of the child was returned on Date . to child placing agency. , Name(s) parent(s). guardian(s). c. neither of the above. I declare that this report has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Signature of adoption attorney Name (type or print) Firm name Address City, state, zip Telephone no. Bar no. Date Signature of agency representative Name (type or print) Agency name Address City, state, zip Telephone no. Do not write below this line - For court use only MCL 710.23d(3); MSA 27.3178(555.23d)(3) PCA 333 (9/97) FOLLOWUP REPORT AFTER TEMPORARY PLACEMENT OF CHILD FOR ADOPTION American LegalNet, Inc. www.FormsWorkFlow.com
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