Request By Adult Adoptee For Identifying Information {DHS-1925} | Pdf Fpdf Doc Docx | Michigan

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Request By Adult Adoptee For Identifying Information {DHS-1925} | Pdf Fpdf Doc Docx | Michigan

Request By Adult Adoptee For Identifying Information {DHS-1925}

This is a Michigan form that can be used for Family Division within Local County, Oakland.

Alternate TextLast updated: 3/26/2007

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Description

REQUEST BY ADULT ADOPTEE FOR IDENTIFYING INFORMATION State of Michigan Department of Human Services I hereby request, from my adoption records, my name before placement in adoption, the names of my biological parents, including their current names, if available, most recent address or addresses of biological parents, and names of biological siblings at the time of termination. CURRENT INFORMATION Current Name (Last, First, Middle) Birth Date Month Current Address (Street Number and Name) Apartment Number Day Year City State Zip Code Telephone Number A/C ( ) ADOPTION INFORMATION Adoptive Name (Last, First, Middle) Name Before Adoption (If Known) Adoptive Mother's Name Adoptive Father's Name Birth Mother's Name Birth Father's Name Name of Probate Court Name of Placing Agency Also, please send me non-identifying information from my file. Additional Comments DISTRIBUTION: Original - Adoption Agency or Court that Finalized the Adoption Copy Keep for Your Records Adult Adoptee's Signature Date AUTHORITY: MCLA 710.68. COMPLETION: Voluntary. PENALTY: None. Department of Human Services (DHS) will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, height, weight, marital status, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area. DHS-1925 (Rev. 8-05) Previous edition may be used. MS Word American LegalNet, Inc. www.FormsWorkflow.com

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