Statement Of Services Performed By Attorney
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Statement Of Services Performed By Attorney Form. This is a Michigan form and can be use in Oakland Local County.
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Tags: Statement Of Services Performed By Attorney, PCA-346, Michigan Local County, Oakland
Approved, SCAO
STATE OF MICHIGAN
6th JUDICIAL CIRCUIT - FAMILY DIVISION
Oakland COUNTY
In the matter of adoptee
STATEMENT OF SERVICES
PERFORMED BY ATTORNEY
7 DAY
21 DAY
FILE NO.
DOB:
Full name of child
I am an attorney representing the
petitioner mother
petitioner father
mother of adoptee
father of adoptee
I state that the following 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
$0.00
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); MSA 27.3178(555.54)(2).
I delcare that this statement has been examined by me and that its contents are true to the best of my information, knowledge, and
belief.
Date
Signature of attorney
Name (print or type)
NOTE: Attach this statement to Form PCA 347,
"Petitioner's Verified Accounting"
Address
City, state, zip
Telephone no.
Do not write below this line - For court use only
PCA 346 (9/97)
STATEMENT OF SERVICES PERFORMED BY ATTORNEY
MCL 710.54(7); MSA 27.3178(555.54)(7)
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