JIS CODE: CAC
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
FILE NO. CONSENT TO ADOPTION BY ADOPTEE
In the matter of
Full name of child
1. I understand that my consent is necessary for this adoption. 2. The judge or referee of the court has fully explained to me that I do not have to sign this consent. 3. I consent to my adoption by
and I consent to taking the above permanently as my legal parent(s), as though parent(s) by birth. 4. I understand that I shall no longer be an heir of my former parent(s), whose rights have been terminated, except if this is a stepparent adoption, in which case I remain an heir of my biological parent whose rights were terminated, and I also become an heir of my adopting parent. 5. I agree that following adoption my name will be .
Adoptee Address City, state, zip
The court made such investigation as it deemed necessary and after I fully explained to the adoptee the fact that s/he was consenting to acquire permanently the adopting parents as legal parents as though the adoptee had been born to the adopting parents, and to the termination of right to be an heir at law of his/her former parent(s) whose rights have been terminated.* The adoptee then voluntarily signed this consent before me. A verbatim record of testimony was made.
*In adult adoptions, see current law in MCL 710.60.
Do not write below this line - For court use only
PCA 307 (9/07)
CONSENT TO ADOPTION BY ADOPTEE
MCL 710.43, MCR 3.801