Michigan > Statewide > Adoption
Consent To Adoption By Guardian PCA 308a - Michigan
| Consent To Adoption By Guardian Form. This is a Michigan form and can be used in Adoption Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Approved, SCAO STATE OF MICHIGAN FILE NO. JUDICIAL CIRCUIT - FAMILY DIVISION CONSENT TO ADOPTION BY GUARDIAN COUNTY In the matter of , adoptee Full name of child 1. I, , am the court appointed guardian for: Name the above named child. the parent of the above named child. The above named child was born at . Date Place 2. I have authority to consent to this adoption by order of the Court (a copy of the order is attached and a copy of my current letters of guardianship are attached.). 3. a. A judge or referee of the court, or other authorized person, has fully explained to me my legal rights as guardian and the legal rights of the parent(s) of the above named child and that I do not have to sign this consent. I understand that if I do sign this consent, my rights as guardian and the legal rights of each parent will be terminated and the child will be placed with: (see i and ii. below) b. A judge or referee of the court, or other authorized person, has fully explained to me, as guardian of the parent, the legal rights of the parent to the above named child and that I do not have to sign this consent. I understand that if I do sign this consent, I voluntarily give up permanently, on behalf of the parent, his/her parental rights, and the child will be placed with: (see i and ii. below) i. the petitioner(s), who filed a petition for the adoption of the adoptee and whose name(s) is/are unknown because identifying information is not being exchanged. ii. , who filed a petition for adoption of the adoptee.4. I have not received or been promised any money or anything of value for the consent to adopt the above named child, except for charges and fees approved by the court. 5. I understand my rights as guardian and the rights of the parent(s) to the child and the right to request a rehearing or to appeal within 21 days after an order is entered terminating the rights of the parent(s) and of myself as guardian. 6. a. As guardian of the above named child, I voluntarily give up permanently my rights as guardian and the rights of each parent to the above named child and consent to the adoption by the petitioner(s). b. As guardian of the parent and on his/her behalf, I voluntarily give up permanently his/her parental rights to the above named child and consent to the adoption by the petitioner(s). 7. This consent involves an American Indian child. The explanation given to me was in a language understood by me or interpreted into my own language if I do not speak English. This consent was given more than 10 days after the birth of the above named child. Date Guardian signature Address City State Zip See reverse side for certification by judge/referee Do not write below this line - For court use only MCL 700.431(1)(c); MSA 27.5431(1)(c), MCL 710.22; MSA 27.3178(555.22), MCL 710.43; MSA 27.3178(555.43), MCL 710.44; MSA 27.3178(555.44),PCA 308a (9/97) CONSENT TO ADOPTION BY GUARDIAN MCL 710.54; MSA 27.3178(555.54), 25 USC 1913(a), MCR 5.751<<<<<<<<<********>>>>>>>>>>>>> 2 CERTIFICATION BY JUDGE/REFEREE An investigation of this consent has been made. At a hearing where a verbatim record of testimony was made, I explained to a. the guardian of the child his/her legal rights and that by signing this consent, the guardian was voluntarily giving up permanently his/her rights to the child for adoption the petitioner(s). b. the guardian of the parent the parents legal rights and that by signing this consent, the guardian was voluntarily giving up permanently, on behalf of the parent, his/her parental rights to the child for adoption by the petitioner(s). The guardian then voluntarily signed this consent before me. Date Judge/Referee Bar no.NOTE: The following direction is necessary only if the consent is signed before another judge of the family division of the circuit court in Michigan[MCL 710.44(a)]. In other cases see MCL 710.44(2),(4). I direct that the consent of Name of guardian be signed before the judge of County, Michigan or his/her designated referee. Date Judge/Referee Bar no.
|
|||||||
