Michigan > Statewide > Adoption
Release Of Child By Guardian PCA 305a - Michigan
| Release Of Child By Guardian 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 RELEASE OF CHILD BY GUARDIAN COUNTY In the matter of 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 sign this release of the above named child for 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 release. I understand that if I do sign this release, my rights as guardian and the legal rights of each parent will be terminated. 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 release. I understand that if I do sign this release, I voluntarily give up permanently, on behalf of the parent, his/her parental rights to the child. 4. I have not received or been promised any money or anything of value for the release of the 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. 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. I release the child to Child placing agency or Michigan Family Independence Agency for the purpose of adoption. 7. This release 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 release was given more than 10 days after the birth of the 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 710.28; MSA 27.3178(555.28), MCL 710.29; MSA 27.3178(555.29),PCA 305a (9/97) RELEASE OF CHILD 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 release 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 release, the guardian was voluntarily giving up permanently his/her rights to the child. b. the guardian of the parent the parents legal rights and that by signing this release, the guardian was voluntarily giving up permanently, on behalf of the parent, his/her parental rights to the child. The guardian then voluntarily signed this release before me. The child named above is over 5 years of age, and the court finds that the child is best served by this release. Date Judge/Referee Bar no.
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