Approved, SCAO JIS CODE: TRP STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY Court address ORDER FOLLOWING HEARING TO TERMINATE PARENTAL RIGHTS, PAGE 1 ORDER _____ OF _____ CASE NO. PETITION NO. Court telephone no. 1. In the matter of name(s), alias(es), DOB 2. Date of hearing: 3. Removal date: Judge/Referee: Bar no. (Specify for each child if different.) 4. An adjudication was held and the child(ren) was/were found to come within the jurisdiction of the court. 5. A petition to terminate parental rights has been filed and notice of hearing on the petition was given as required by law. 6. Specific findings of fact and law regarding this proceeding have been made on the record or by separate written opinion of the court. THE COURT FINDS: 7. a. Reasonable efforts were made to preserve and unify the family to make it possible for the child(ren) to safely return to the child(ren)'s home. Those efforts were unsuccessful. b. Reasonable efforts were not made to preserve and unify the family because it was previously determined in a prior court order to be detrimental to the child(ren)'s health and safety. c. Reasonable efforts were not required to preserve and reunify the family as determined in a prior court order. (This requires a permanency planning hearing within 28 days.) 8. The child(ren) is/are Indian as defined in MCR 3.002(12). a. Active efforts have not been made. b. Active efforts have been made to provide remedial services and rehabilitative programs designed to prevent the breakup of the Indian family. These efforts have proved unsuccessful and there is evidence beyond a reasonable doubt, including qualified expert witness testimony, that continued custody of the child(ren) by the parent(s) or Indian custodian will likely result in serious emotional or physical damage to the child(ren). c. Active efforts have been made to provide remedial services and rehabilitative programs designed to prevent the breakup of the Indian family. These efforts have proved successful and there is not evidence beyond a reasonable doubt, including qualified expert witness testimony, that continued custody of the child(ren) by the parent(s) or Indian custodian will likely result in serious emotional or physical damage to the child(ren). 9. There is clear and convincing evidence that a statutory basis exists for terminating the parental rights of Name(s) of parent(s) , parent(s) of the child(ren), 10. Termination of parental rights (SEE SECOND PAGE) is is not in the best interests of the child(ren). NOTE: If a child remains in foster care and parental rights are terminated in accordance with MCL 712A.19a(2), a permanency planning hearing must be held within 28 days. If proper notice has already been given, the permanency planning hearing can be conducted immediately following the termination hearing. This is especially useful in obtaining a uniform date for future permanency planning hearings when parental rights have been terminated to more than one child and the removal dates of the children are different. Use form JC 76. USE NOTE: Do not use this form when terminating parental rights after release under the adoption code. Use forms PCA 318 and PCA 322. If one parent has signed a release under the adoption code, do not include his or her name in the order. JC 63 (9/15) Do not write below this line - For court use only 25 USC 1912, MCL 400.201 et seq., MCL 712A.18, MCL 712A.19a, MCL 712A.19b, MCL 712A.20, MCR 3.977 American LegalNet, Inc. www.FormsWorkFlow.com ORDER FOLLOWING HEARING TO TERMINATE PARENTAL RIGHTS, PAGE 1 Approved, SCAO JIS CODE: TRP STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY Court address ORDER FOLLOWING HEARING TO TERMINATE PARENTAL RIGHTS, PAGE 2 ORDER _____ OF _____ CASE NO. PETITION NO. Court telephone no. 1. In the matter of IT IS ORDERED: 11. The parental rights of Name(s) of parent(s) are terminated, and additional efforts for reunification of the child(ren) with the parent(s) shall not be made. 12. a. The child(ren) is/are continued in the temporary custody of this court and remain in placement with the department for care and supervision. b. The child(ren) is/are committed to the department for permanency planning, supervision, care, and placement under MCL 400.203. 13. While the child(ren) is/are placed out of the home, the friend of the court shall redirect current support due on behalf of the child(ren) to the person with whom the child(ren) is/are placed as long as that person is not receiving foster care maintenance payments. Unpaid child support that charged during the unfunded placement shall also be redirected unless otherwise assigned. 14. The Director of the department is appointed special guardian to receive any benefits now due or to become due the child(ren) from the government of the United States. 15. Other: (Include reimbursement provisions as required by MCL 712A.18[2]. Attach separate sheet.) 16. The court reserves the right to enforce payments of reimbursement that have accrued up to and including the date of this order. 17. The supplemental petition to terminate the parental rights of 18. A review hearing permanency planning hearing Name(s) of parent(s) is denied. . will be held Date Recommended by: Referee signature Date Date Judge Reference Note: The term "department" refers to the Department of Health and Human Services. JC 63 (9/15) ORDER FOLLOWING HEARING TO TERMINATE PARENTAL RIGHTS, PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com