Request By Adult Adoptee For Identifying Information
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Request By Adult Adoptee For Identifying Information Form. This is a Michigan form and can be use in Oakland Local County.
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Tags: Request By Adult Adoptee For Identifying Information, DHS-1925, Michigan Local County, Oakland
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)
City
Day
Year
Apartment Number
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
AUTHORITY: MCLA 710.68.
COMPLETION: Voluntary.
PENALTY: None.
DHS-1925 (Rev. 8-05) Previous edition may be used. MS Word
Adult Adoptee’s Signature
Date
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.
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