Petition To Issue Notice Of Intent To Release Or Consent
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Petition To Issue Notice Of Intent To Release Or Consent Form. This is a Michigan form and can be use in Oakland Local County.
Tags: Petition To Issue Notice Of Intent To Release Or Consent, PCA313, Michigan Local County, Oakland
Approved, SCAO
FILE NO.
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
PETITION TO ISSUE NOTICE OF
INTENT TO RELEASE OR CONSENT
In the matter of
Petitioner
1. I am pregnant out of wedlock and intend to release the expected child for adoption or to consent to the child's adoption.
2. The approximate date of conception was
at the following location:
Date
Location, including city, county, and state
3. The name and address of the putative father of my expected child is: *
Name (type or print)
Address
City
State
Zip
4. I request the court to notify the putative father about his rights to file a notice of intent to claim paternity by issuing and
serving upon him a notice of intent to release or consent.
I declare that this petition has been examined by me and that its contents are true to the best of my information, knowlege, and belief.
Date
Signature of petitioner
Attorney signature
Attorney name (type or print)
Bar no.
Address
City, state, zip
Name (type or print)
Address
Telephone no.
City, state, zip
Telephone no.
*The petition may include more than one putative father where circumstances warrant it.
Do not write below this line - For court use only
MCL 710.33; MCL 710.34, MCR 3.801
PCA 313 (9/07)
PETITION TO ISSUE NOTICE OF INTENT TO RELEASE OR CONSENT
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