JIS CODE: OTR
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
FILE NO. ORDER PLACING CHILD AFTER CONSENT
In the matter of
Full name of child
1. Date of hearing: THE COURT FINDS: 2. A petition for an order of adoption has been filed.
3. A report of investigation has been filed and reviewed by the court. 4. The best interests of the adoptee will be served by the adoption. 5. The rights of both parents or the person in loco parentis have been terminated. IT IS ORDERED: 6. The adoptee is made a ward of this court for purposes of adoption and placement in the home of the adoptive parents, , is approved.
Court agent or employee, child-placing agency or Michigan Department of Human Services
shall supervise the adoptee in the home and months.
shall make reports to the court regarding the adjustment of the adoptee in the home every
8. The adoptive parent(s) may consent to all medical, surgical, dental, optical, psychological, educational, and related services for the adoptee.
Do not write below this line - For court use only
PCA 320 (9/07)
ORDER PLACING CHILD AFTER CONSENT
MCL 710.51, MCL 710.52