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JIS CODE: MPS

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY

ORDER DETERMINING MATERNITY/PATERNITY OF SURRENDERED NEWBORN CHILD

FILE NO.

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. THE COURT FINDS: 3. Notice of hearing was given to or waived by all interested parties. 4. a. The result of the maternity testing b. The result of the paternity testing 5. a. The petitioner,
Name

is is

is not is not

admissible. admissible. , is is not the biological mother of the

surrendered newborn child. b. The petitioner,
Name

,

is

is not

the biological father of the

surrendered newborn child. IT IS ORDERED: 6. The petition for change of custody is dismissed. 7. A hearing on the petition for change of custody shall be held on
Time and location Date

at .

before Hon.

Date

Judge

Do not write below this line - For court use only

CCFD 04a (9/07)

ORDER DETERMINING MATERNITY/PATERNITY OF SURRENDERED NEWBORN CHILD

MCL 712.10(3), MCL 712.11(5)