Michigan > Statewide > Juvenile
Request For Confidentiality JC 50 - Michigan
| Request For Confidentiality Form. This is a Michigan form and can be used in Juvenile Statewide . |
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Approved, SCAO STATE OF MICHIGAN CASE NO. JUDICIAL CIRCUIT - FAMILY DIVISION PETITION NO. REQUEST FOR CONFIDENTIALITY COUNTY Court address Court telephone no.1. In the matter of (name(s), alias(es), DOB) 2. The minor is an American Indian child and either is eligible to be place d for adoption or presently is in an adoptive placement. 3. I, , am the childs natural father and ask that my identity be kept Name confidential. 4. I, , am the childs natural mother and ask that my identity be kept Name confidential Signature Subscribed and sworn to before me on , County, Michigan. Date My commission expires: Signature: Date Deputy clerk/Notary public Use note to court: This Request must be sent to the Secretary of the In terior with the final order of adoption if the minor is adopted. Do not write below this line - For court use only JC 50 (6/03) REQUEST FOR CONFIDENTIALITY 25 USC 1951(c)
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