Supplemental Petition And Affidavit To Terminate Parental Rights Of Noncustodial Parent
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Supplemental Petition And Affidavit To Terminate Parental Rights Of Noncustodial Parent Form. This is a Michigan form and can be use in Adoption Statewide.
Tags: Supplemental Petition And Affidavit To Terminate Parental Rights Of Noncustodial Parent, PCA 302, Michigan Statewide, Adoption
Approved, SCAO
JIS CODE: SPT
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
In the matter of
FILE NO.
SUPPLEMENTAL PETITION AND
AFFIDAVIT TO TERMINATE PARENTAL
RIGHTS OF NONCUSTODIAL PARENT
DOB:
Full name of child
, adoptee
SUPPLEMENTAL PETITION
I,
, am the custodial parent of the child named above, and I request
Name (type or print)
that the parental rights of
, the noncustodial parent of the child, be
Name (type or print)
terminated because of lack of support of and parenting time with the child.
Date
Custodial parent signature
AFFIDAVIT
1. I have joined in a petition with
on
, whom I married
Name (type or print)
, requesting the adoption of the child named above and the termination of the
Date
parental rights of the noncustodial parent named above.
2. The noncustodial parent and I were divorced on
. A copy of the judgment of
Date
divorce and any subsequent orders are attached and filed with the court.
3. The noncustodial parent acknowledged paternity on
Date
. A copy of the acknowledgment
of paternity is attached and filed with the court.
4. I have legal custody of the child.
5.
a. A support order has been entered and the noncustodial parent has failed to substantially comply with the order for a
period of two years or more before the petition for adoption was filed.
b. A support order has not been entered and the noncustodial parent, having the ability to support the child, has failed or
neglected to provide regular and substantial support for two years or more before the petition for adoption was filed.
6. The noncustodial parent has had the ability to visit, contact, and communicate with the child and has regularly and substantially
failed or neglected to do so for a period of two years or more before the petition for adoption was filed.
(PLEASE SEE OTHER SIDE)
Do not write below this line - For court use only
PCA 302 (11/05)
SUPPLEMENTAL PETITION AND AFFIDAVIT TO TERMINATE PARENTAL RIGHTS OF NONCUSTODIAL
MCL 710.26, MCL 710.51(6), MCR 3.801
PARENT
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7. The last known address of the noncustodial parent is
8.
a. The noncustodial parent is living at the above address.
b. The noncustodial parent is not living at the above address, and I have taken the following steps to locate him/her.
Attorney signature
Date
Attorney name (type or print)
Bar no.
Address
Address
City, state, zip
Telephone no.
Subscribed and sworn to before me on
My commission expires:
Signature of custodial parent petitioner
Date
Date
City, state, zip
,
Signature:
Telephone no.
County, Michigan.
Notary public/Deputy clerk
Notary public, State of Michigan, County of
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