Request For Confidentiality
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Request For Confidentiality Form. This is a Michigan form and can be use in Juvenile Statewide.
Tags: Request For Confidentiality, JC 50, Michigan Statewide, Juvenile
Approved, SCAO
JIS CODE: RQC
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
REQUEST FOR CONFIDENTIALITY
COUNTY
CASE NO.
PETITION NO.
Court address
Court telephone no.
1. In the matter of
name(s), alias(es), DOB
2. The minor is an American Indian child and either is eligible to be placed for adoption or presently is in an adoptive placement.
3. I,
, am the child's natural father and ask that my identity be kept
Name
confidential.
4. I,
, am the child's natural mother and ask that my identity be kept
Name
confidential.
Signature
Subscribed and sworn to before me on
My commission expires:
,
Date
Date
Signature:
County, Michigan.
Deputy clerk/Notary public
Notary public, State of Michigan, County of
Use note to court: This Request must be sent to the Secretary of the Interior with the final order of adoption if the minor is adopted.
Do not write below this line - For court use only
JC 50 (11/05)
REQUEST FOR CONFIDENTIALITY
25 USC 1951(c)
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