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Here is the text we could read:

In the matter of

Full name of child

City, county, and state

1. I am the mother of the adoptee named above who was born out of wedlock on

Date

, adoptee

. The adoptee resides at

Address City State Zip

2. An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor

has been previously filed in

Court, Case Number

, was

assigned to Judge

, and

remains

is no longer

pending.

3. I plan to sign a

release

consent giving up my parental rights to the child.

4. I have joined with my spouse in a petition for adoption.

5. The child is an Indian child as defined in MCR 3.002(12). The identity of the tribe is

Name of tribe, if known

6. The putative father of my child is:

Name (type or print)

Birthdate (if unknown, state if over 18 years old)

7. For part or all of the time from conception to the date the child was born, I was married to

Name (type or print)

whose last-known address is

. He is not the father of the child.

Address

City, state, zip

Do not write below this line - For court use only(SEE SECOND PAGE)PCA 310 (6/17) PETITION FOR HEARING TO IDENTIFY FATHER AND DETERMINE OR TERMINATE HIS RIGHTSMCL 710.22(d), MCL 710.36, 25 USC 1901 et seq., MCL 712B.1 et seq., MCR 3.801, MCR 3.803Approved, SCAO JIS CODE: PHTSTATE OF MICHIGANJUDICIAL CIRCUIT - FAMILY DIVISIONCOUNTY PETITION FOR HEARING TO IDENTIFYFATHER AND DETERMINE ORTERMINATE HIS RIGHTSFILE NO.Petition for Hearing to Identify Father and Determine/Terminate His Rights

(6/17) Page

File No.

8. I request that the court hold a hearing to determine the identity of the father of my child and to determine or terminate his
parental rights.

City, state, zip Telephone no.

Attorney signature

Date

Signature of petitioner

Attorney name (type or print) Bar no.

Name (type or print)

Address

Agency Contact Information:

Name of agency representative (type or print)

Agency name

Telephone no.

E-mail

Address

City, state, zip

CERTIFICATION BY PARENT/GUARDIAN OF UNEMANCIPATED MINOR PARENT

I certify that I am the

parent

legal guardian

Name of parent of child

who is an unemancipated minor parent of the child. I have reviewed this petition and agree with it.

Signature of parent/guardian

Signature of witness

Name of parent/guardian (print)

Name of witness (print)

Date

Address

City, state, and zip

PCA 310, Petition for Hearing to Identify Father and Determine or Terminate His Rights

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): 2
Fields(s): 53
Average fields per page: 26
Reading Level: Grade 6
LIST Grouping(s): FA-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

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.

stat_e_n_l_county was STATE OF MICHIGAN JUDICIAL CIRCUIT FAMILY DIVISION COUNTY (0.64 conf)
full_name_child was Full name of child (0.35 conf)
adoptee was adoptee (0.41 conf)
signature_date__1 was Date (1.00 conf)
city_county_state was City county and state (0.52 conf)
action_division_involving was 2 An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor (0.37 conf)
plan_sign was 3 I plan to sign a (0.36 conf)
joined_spouse_petition was 4 I have joined with my spouse in a petition for adoption (0.39 conf)
child_indian_mc_identity_tribe was 5 The child is an Indian child as defined in MCR 300212 The identity of the tribe is (0.37 conf)
court_case_number was Court Case Number (0.46 conf)
was was was (0.41 conf)
previously_filed was has been previously filed in (0.40 conf)
remains was remains (0.32 conf)
longer was is no longer (0.37 conf)
release was release (0.35 conf)
consent was consent (0.47 conf)
name_tribe_known was Name of tribe if known (0.35 conf)
putative_father_child was 6 The putative father of my child is (0.44 conf)
name_type_print__1 was Name type or print (0.45 conf)
unknown_state_years_old was Birthdate if unknown state if over 18 years old (0.41 conf)
users1_address_line_one was Address (1.00 conf)
time_conception_child_married was 7 For part or all of the time from conception to the date the child was born I was married to (0.35 conf)
undefined__1 was undefined (0.38 conf)
undefined__2 was undefined_2 (0.39 conf)
name_type_print__2 was Name type or print_2 (0.40 conf)
whose_lastknown_address was whose lastknown address is (0.41 conf)
text was Text1 (0.35 conf)
of was of (0.38 conf)
file was File No (0.38 conf)
attorney_name_type_print was Attorney name type or print (0.50 conf)
bar was Bar no (0.41 conf)
address__1 was Address_2 (0.35 conf)
users1_address_line_two was City state zip (1.00 conf)
telephone__1 was Telephone no (0.44 conf)
agency_representative_type was Name of agency representative type or print (0.46 conf)
agency_name was Agency name (0.47 conf)
telephone__2 was Telephone no_2 (0.45 conf)
signature_date__2 was Date_2 (1.00 conf)
name_type_print__3 was Name type or print_3 (0.40 conf)
address__2 was Address_3 (0.35 conf)
city_state_zip__1 was City state zip_2 (0.35 conf)
telephone__3 was Telephone no_3 (0.45 conf)
address__3 was Address_4 (0.35 conf)
city_state_zip__2 was City state zip_3 (0.35 conf)
email was Email (0.38 conf)
parent was parent (0.35 conf)
legal_guardian was legal guardian (0.50 conf)
name_parent_child was Name of parent of child (0.46 conf)
signature_date__3 was Date_3 (1.00 conf)
name_parentguardian_print was Name of parentguardian print (0.40 conf)
address__4 was Address_5 (0.35 conf)
city_state_zip__3 was City state and zip (0.38 conf)
name_witness_print was Name of witness print (0.47 conf)

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

PCA 310, Petition for Hearing to Identify Father and Determine or Terminate His Rights

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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