Approved, SCAO Original - Court Copies as needed JIS CODE: NCI STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION FILE NO. NOTICE OF ADOPTION PROCEEDINGS CONCERNING AN INDIAN CHILD Court telephone no. COUNTY Court address In the matter of Full name of child TO: (Name and telephone no. of natural father or Indian custodian. State if unknown.) (Name and telephone no. of natural mother or Indian custodian. State if unknown.) (Name and telephone no. of Tribal chairperson. State if unknown.) Bureau of Indian Affairs, Midwest Regional Office Norman Pointe II 5600 West American Blvd., Suite 500 Bloomington, MN 55437 (612) 725-4571 or 4572 TAKE NOTICE: 1. A petition for adoption petition for direct placement adoption (Use only if identity of parents, custodian, or tribe is unknown. If grandparent[s] are known, please attach a sheet with name[s] and date[s] of birth.) has been filed. 2. A copy of the petition is attached to this notice. 3. You have the absolute right to intervene in this proceeding and, absent objection by either Indian parent, you have the right to petition the court to have this case transferred to the tribal court of the Tribe. The tribal court may decline the transfer. 4. You may object to a transfer of this case to the tribal court. 5. As a parent or Indian custodian, you have the right to a court-appointed attorney if you are determined indigent. If you intend to request a court-appointed attorney, you should contact the court immediately by telephone or in writing. 6. All parties notified shall keep confidential the information contained in this notice concerning this particular proceeding. This notice shall not be handled by anyone not needing the information contained in the notice in order to exercise the tribe's rights under the Indian Child Welfare Act and the Michigan Indian Family Preservation Act. If you require special accommodations to use the court because of a disability or if you require a foreign language interpreter to help you fully participate in court proceedings, please contact the court immediately to make arrangements. USE NOTE: This notice must be sent to the parties by registered mail, return receipt requested. NOTICE OF ADOPTION PROCEEDINGS CONCERNING AN INDIAN CHILD 25 USC 1912, MCL 712B.9, MCL 712B.27, MCR 3.802(A)(3) PCA 352 (2/15) American LegalNet, Inc. www.FormsWorkFlow.com