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Here is the text we could read:

STATE OF MICHIGAN

JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY

STATEMENT OF SERVICES
PERFORMED BY ATTORNEY
21-DAY

7-DAY

FILE NO.

In the matter of adoptee

Full name of child

DOB:

I am an attorney representing the

petitioner(s) for adoption.

mother of adoptee.

father of adoptee.

I state that the following list itemizes the services performed and any fees, compensation, or other thing of value received by or
agreed to be paid to me for, or incidental to, the adoption of the child.

Date

Service Performed

Fee, Compensation, or Other Value

SUBTOTAL FROM 7-Day Statement of Services Performed by Attorney

TOTAL

I represent a party in this direct placement adoption. I have not requested or received any compensation for the activities

described in MCL 710.54(2).

I declare that this statement has been examined by me and that its contents are true to the best of my information, knowledge,
and belief.

Date

Note: Attach this statement to form PCA 347,
“Petitioner’s Verified Accounting”

Signature of attorney

Address

Name (print or type) Bar no.

City, state, zip Telephone no.

Approved, SCAOJIS CODE: VSLDo not write below this line - For court use onlyPCA 346 (6/17) STATEMENT OF SERVICES PERFORMED BY ATTORNEYMCL 710.54(7)

PCA 346, Statement of Services Performed by Attorney

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/adoptions-court-forms (2023-03)
Page(s): 1
Fields(s): 59
Average fields per page: 59
Reading Level: Grade 8
LIST Grouping(s): Unknown

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

cirno was cirno (0.60 conf)
county was county (0.39 conf)
docket_number was caseno (1.00 conf)
casename was casename (0.35 conf)
users1_birthdate was dob (1.00 conf)
service__1 was service1 (0.35 conf)
fee__1 was fee1 (0.35 conf)
none__1 was none1 (0.35 conf)
service__2 was service2 (0.35 conf)
fee__2 was fee2 (0.35 conf)
none__2 was none2 (0.35 conf)
service__3 was service3 (0.35 conf)
fee__3 was fee3 (0.35 conf)
none__3 was none3 (0.35 conf)
service__4 was service4 (0.35 conf)
fee__4 was fee4 (0.35 conf)
none__4 was none4 (0.35 conf)
service__5 was service5 (0.35 conf)
fee__5 was fee5 (0.35 conf)
none__5 was none5 (0.35 conf)
service__6 was service6 (0.35 conf)
fee__6 was fee6 (0.35 conf)
none__6 was none6 (0.35 conf)
service__7 was service7 (0.35 conf)
fee__7 was fee7 (0.35 conf)
none__7 was none7 (0.35 conf)
service__8 was service8 (0.35 conf)
fee__8 was fee8 (0.35 conf)
none__8 was none8 (0.35 conf)
service__9 was service9 (0.35 conf)
fee__9 was fee9 (0.35 conf)
none__9 was none9 (0.35 conf)
service__10 was service10 (0.35 conf)
fee__10 was fee10 (0.35 conf)
none__10 was none10 (0.35 conf)
fee__11 was fee11 (0.35 conf)
total was total (0.32 conf)
party was party (0.32 conf)
sdate was sdate (0.35 conf)
users1_name was name (1.00 conf)
users1_address_line_one was address (1.00 conf)
users1_address_city was city (1.00 conf)
telno was telno (0.35 conf)
check_box__1 was Check Box1 (0.52 conf)
check_box__2 was Check Box2 (0.37 conf)
check_box__3 was Check Box3 (0.37 conf)
check_box__4 was Check Box4 (0.37 conf)
check_box__5 was Check Box5 (0.37 conf)
signature_date__1 was date1 (1.00 conf)
signature_date__2 was date3 (1.00 conf)
signature_date__3 was date6 (1.00 conf)
signature_date__4 was date7 (1.00 conf)
signature_date__5 was date8 (1.00 conf)
signature_date__6 was date9 (1.00 conf)
signature_date__7 was date10 (1.00 conf)
signature_date__8 was date2 (1.00 conf)
signature_date__9 was date4 (1.00 conf)
signature_date__10 was date5 (1.00 conf)
text was Text6 (0.35 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

PCA 346, Statement of Services Performed by Attorney

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02