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Notice To Putative Father And Custody Statement PCA 316 - Michigan
| Notice To Putative Father And Custody Statement Form. This is a Michigan form and can be used in Adoption Statewide . |
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Approved, SCAO STATE OF MICHIGAN FILE NO. JUDICIAL CIRCUIT - FAMILY DIVISION NOTICE TO PUTATIVE FATHER COUNTY AND CUSTODY STATEMENT In the matter of , minor adult. TO: , an unemancipated minor. Putative father intends to file a petition, 1. Name (type or print) has filed a petiton with the court,stating that: . a. She is the mother of Name of child (type or print) an unborn child expected on or about . Date b. You are the father of the child. intends to sign a release or consent relinquishing her rights to the child. c. She has joined with her husband in a petition for adoption. 2. The law provides that as a putative father, you have a right to request custody of the child. The law also provides that your failure to appear at the hearing on the petition shall constitute a denial of your interest in the custody of the child, which shall result in the courts termination of your parental rights to the child. 3. If you do not want to request custody of the child, complete the section below and mail or deliver to . CUSTODY STATEMENT OF PUTATIVE FATHER 1. I voluntarily state: (check one) I am the father of the child and deny any interest in the custody of the child. I may be the father of the child and deny any interest in the custody of the child. I am not the father of the child. 2. I give up my right to notice of the time and place of hearing to identify the childs father and determine or terminate his rights. I declare that this "Custody Statement of Putative Father" has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Date Signature of witness Signature of putative father Name of witness (type or print) Address Address City, state, zip Telephone no. City, state, zip Telephone no. Signature of parent/guardian/guardian ad litem of minor putative father Do not write below this line - For court use only MCL 710.36; MSA 27.3178(555.36),PCA 316 (9/97) NOTICE TO PUTATIVE FATHER AND CUSTODY STATEMENT MCL 710.37; MSA 27.3178(555.37), MCR 5.751
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