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Approved, SCAO

JIS CODE: ODN

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

FILE NO. ORDER DETERMINING CUSTODY OF SURRENDERED NEWBORN CHILD

COUNTY

In the matter of
Full name of child

, a surrendered newborn child

1. Date of hearing:

Judge:

Bar no.

2. A petition for custody of the surrendered newborn child was filed. The required testing for maternity and/or paternity has been completed and the results were served on the parent(s) and filed with the court. 3. Findings of fact and conclusions of law regarding the best interests of the newborn child as set forth in MCL 712.14 were made on the record. THE COURT FINDS: 4. Notice of hearing was given to or waived by all interested parties. 5. The result of the maternity paternity test is 99% or higher, and the summary report is admissible. 6. The petitioner, , is is not the biological mother of the surrendered newborn child. 7. The petitioner, , is is not the biological father of the surrendered newborn child. 8. a. Custody of the surrendered newborn child should should not be given to the mother. b. Custody of the surrendered newborn child should should not be given to the father. 9. It is in the best interests of the surrendered newborn child to transfer custody as follows:

IT IS ORDERED: 10. The petition for change of custody is dismissed/denied. 11. The petition for change of custody is granted and
mother or father or both

Name(s)

, the custody of the newborn child. Custody shall be as follows:

shall have

legal

physical

transferred from the

child-placing agency

prospective adoptive parent(s)

Court jurisdiction 12. The parental rights of

shall continue until
Name(s) of parent(s)

Date

.

is relinquished. are terminated. ,a

Custody and care of the newborn child is granted to child-placing agency. The prior court order dated the surrendered newborn child with the prospective adoptive parent(s) is continued.

that authorizes placement of

Date

Judge Do not write below this line - For court use only

CCFD 06 (9/07)

ORDER DETERMINING CUSTODY OF SURRENDERED NEWBORN CHILD

MCL 712.14, MCL 712.15