Approved, SCAO JIS CODE: NIF STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY NOTICE OF HEARING TO IDENTIFY FATHER AND DETERMINE OR TERMINATE HIS RIGHTS FILE NO. In the matter of TO: , adoptee adoptee is an Indian child TAKE NOTICE: On Building Date Address at Time , in the City State courtroom, , a hearing Date before Name , Title will be held to determine the identity of the father of the child named above who was born at City, county, and state to Mother's name , who has signed or intends to sign a release or consent permanently giving up her parental rights to the child. joined with her husband in a petition for adoption. At the hearing the rights of the father shall be determined or terminated. YOUR FAILURE TO APPEAR AT THIS HEARING SHALL CONSTITUTE A DENIAL OF YOUR INTEREST IN THE CUSTODY OF THE CHILD, WHICH SHALL RESULT IN THE COURT'S TERMINATION OF YOUR PARENTAL RIGHTS TO THE CHILD. If you choose to attend this hearing and 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. Date Deputy clerk Attorney name and bar no./Agency/Michigan Department of Health and Human Services Address City, state, zip Telephone no. Do not write below this line - For court use only MCL 712B.9, MCL 712B.13(1)(b), MCR 3.801, MCR 3.802, MCR 3.803 PCA 311 (2/15) NOTICE OF HEARING TO IDENTIFY FATHER AND DETERMINE OR TERMINATE HIS RIGHTS American LegalNet, Inc. www.FormsWorkFlow.com