Approved, SCAO
JIS CODE: DIL
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
FILE NO. DECLARATION OF INABILITY TO IDENTIFY/LOCATE FATHER
COUNTY
In the matter of
Full name of child
, adoptee
1. I am the mother of the adoptee named above who was born out of wedlock on
City, county, and state
Date
at .
2. The father of my child is
Name (type or print)
.
cannot be identified for the following reasons:
3. The father's address or location is not known and cannot be determined. I have made the following reasonable attempt(s) to locate (State specifically what attempts you made; provide names and addresses if known.) him: contacted his family: contacted his friends: visited his last-known address: letter to his last-known address: other:
I declare that this declaration has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Date Attorney signature Attorney name (type or print) Address City, state, zip Telephone no. Bar no. Signature of petitioner Name (type or print) Address City, state, zip Telephone no.
Do not write below this line - For court use only
PCA 315 (9/07)
DECLARATION OF INABILITY TO IDENTIFY/LOCATE FATHER
MCL 710.22(d), MCL 710.36, MCL 710.37, MCR 5.751, MCR 5.752(B)