Adoption Forms

Adoptee is over the age of 18, regardless of who is petitioning to adopt. Adult Adoptee must provide consent to adoption by petitioning parent at a Court hearing Parental rights are not terminated in Adult Adoptions, however, the Court is required to provide biological parents with notice of the adoption proceedings.

• Adult Adoption Checklist
• Petition for Adult Adoption (SCAO form PCA 301)
• Appearance of Attorney (SCAO form JC 07), if applicable
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Attorney’s Statement of Services (SCAO form PCA 346), if applicable
• Livingston County LEIN Request Form
• Livingston County Adult Adoption Questionnaire
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information
  • This form must be filled out even if electing to not amend the birth certificate following the adoption

Temporary Placements

Must be submitted within 48 hours of placement

• Appearance of Attorney (SCAO form JC 07), if applicable
• Statement of Parent/Guardian Authorizing Temporary Placement of Child for Adoption (SCAO form PCA 329)
• Statement of Parent/Guardian  Transferring Physical Custody of Child for Adoption (SCAO form PCA 330)
• Statement of Child-Placing Agency Transferring Physical Custody of Child for Adoption (SCAO form PCA 331)
• Statement of Prospective Adoptive Parent Transferring Physical Custody of Child for Adoption (SCAO form PCA 332)

30-Day Document Requirements

Must be submitted within 30 days of the temporary placement of the child

• Follow-Up Report After Temporary Placement of Child for Adoption (SCAO form PCA 333)

Adoption Petition Packet Requirements

Must be submitted within 45 days of the temporary placement of the child

• Direct Placement Adoption Checklist
• Petition for Direct Placement Adoption (SCAO form PCA 301a)
• Report on Appeals and Rehearings
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Statement of Services Performed by Agency (SCAO form PCA 345)
• Attorney’s Statement of Services (SCAO form PCA 346), if applicable
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information

Out of Court Consent Requirements

• Out-of-Court Consent to Direct Placement Adoption by Parent (SCAO form PCA 355)
• Statement to Accompany Consent in Direct Placement Adoption (SCAO form PCA 339)
• Verified Declaration About Paternity (Out-of-Court Consent) (SCAO Form PCA 356)
• Addendum A to Verified Declaration About Paternity (Father’s Name and Whereabouts Known) (SCAO form PCA 356a)
• Addendum B to Verified Declaration About Paternity (Father’s Name but Whereabouts Unknown) (SCAO form PCA 356b)
• Addendum C to Verified Declaration About Paternity (Father’s Name and Whereabouts Unknown) (SCAO form PCA 356c)

Petitioner has Legal Guardianship of Adoptee by Court order. The legal parents must voluntarily consent to adoption at a private hearing before a Judge or Referee of the Circuit Court. If the legal parents are unwilling to provide consent, and have not provided for the welfare of the adoptee, the Petitioners may filed a petition seeking the termination of parental rights through a Neglect/Abuse case under the Juvenile Code with the Juvenile Court. This must be done prior to the commencement of an adoption proceeding. The Court cannot assist in the filing of a Neglect/Abuse Petition.

• Legal Guardian Adoption Checklist
• Petition for Guardian Adoption (SCAO form PCA 301)
• Appearance of Attorney (SCAO form JC 07), if applicable
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Attorney’s Statement of Services (SCAO form PCA 346), if applicable
• Livingston County LEIN Request Form
• Livingston County DHHS Clearance Request Form
• Livingston County Legal Guardian Adoption Home Study Questionnaire
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information

Adoptee and Petitioner are related within the 5th Degree. Petitioner may or may not have Legal Guardianship of Adoptee by Court order. The legal parents must voluntarily consent to adoption at a private hearing before a Judge or Referee of the Circuit Court. If the legal parents are unwilling to provide consent, and have not provided for the welfare of the adoptee, the Petitioners may filed a petition seeking the termination of parental rights through a Neglect/Abuse case under the Juvenile Code with the Juvenile Court. This must be done prior to the commencement of an adoption proceeding. The Court cannot assist in the filing of a Neglect/Abuse Petition.

• Relative Adoption Checklist
• Petition for Relative Adoption (SCAO form PCA 301)
• Appearance of Attorney (SCAO form JC 07), if applicable
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Attorney’s Statement of Services (SCAO form PCA 346), if applicable
• Livingston County LEIN Request Form
• Livingston County DHHS Clearance Request Form
• Livingston County Relative Adoption Home Study Questionnaire
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information

• MCI/Permanency Court Ward Adoption Checklist
• Petition for Stateward Adoption (SCAO form PCA 301)
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Statement of Services Performed by Agency, 7 day and 21 day (SCAO form PCA 345)
• Attorney’s Statement of Services, 7 day and 21 day (SCAO form PCA 346), if applicable
• Report on Appeals and Rehearings
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information

Adoptee is under the age of 18. The adoptee must be aware of the adoption process, as an age appropriate interview about the adoption will be conducted during the home study investigation and the adoptee will be asked about the adoption. The custodial parent who is married to the petitioning adoptive parent is also an adoptive petitioner as they are joining their spouse in the petition for adoption; therefore, must fill out the packet as such. The petitioning custodial parent of the adoptee must have custody by way of a Court order of the adoptee per MCL 710.51(6) to have standing to file a supplemental petition to terminate rights where consent by the other parent cannot be obtained.

• Stepparent Adoption Checklist
• Petition for Stepparent Adoption (SCAO form PCA 301b)
• Appearance of Attorney (SCAO form JC 07), if applicable
• Petitioner’s Verified Accounting (SCAO form PCA 347)
• Supplement to Petitioner’s Verified Accounting (SCAO form PCA 347a)
• Attorney’s Statement of Services (SCAO form PCA 346), if applicable
• Livingston County LEIN Request Form
• Livingston County DHHS Clearance Request Form
• Livingston County Stepparent Adoption Home Study Questionnaire
• Adoption Report Required to Establish New Michigan Birth Record
  • Only if Adoptee was born in the State of Michigan
  • If Adoptee was born elsewhere, refer to the Checklist for information

Voluntary Consent

If the other legal parent of the adoptee is willing to Consent to the adoption and voluntarily terminate their parental rights, then a Consent to Adoption by Parent must be signed in Court at a private hearing by the adoptee’s other legal parent. The Consent hearing will be scheduled after the Petition for Adoption has been filed and the home study investigation has been completed. If the consenting legal parent lives outside of the State of Michigan, ask the Adoption Caseworker prior to submitting the Adoption Packet about how to obtain the Consent. If the legal parent of the adoptee is willing to Consent to the adoption, you must also provide the following:

Proof that the person who is consenting to the adoption is the legal parent (this can be accomplished through any of the following:)

• Affidavit of Parentage / Acknowledgement of Paternity
• Order of Filiation
• If biological parents were married at the time of adoptee’s birth and are listed on the birth certificate
  • You must also provide the marriage certificate for this marriage
• Order of Adoption

It is the responsibility of the petitioner(s) to obtain and provide the complete current address of the other parent who is willing to Consent to the adoption and provide it to the Court. Upon accepting the legal parent’s consent, the Court will enter an Order Terminating Parental Rights.

Involuntary Termination

• Involuntary Termination Information Sheet
• Supplemental Petition and Affidavit to Terminate Parental Rights of Noncustodial Parent (SCAO form PCA 302)
• Declaration of Diligent Search and Inability to Identify/Locate Parent (Livingston County Form)
• Statement of Contact with Non-Custodial Parent (Livingston County Form)
• Petition for Hearing to Identify Father and Determine or Terminate his Rights (SCAO form PCA 310)
• Notice to Putative Father and Custody Statement (SCAO form PCA 316)
• Declaration of Inability to Identify/Locate Father (SCAO form PCA 315)

Petition to Amend Adoption Petition

• Petition to Amend Adoption Petition – This form should be used if the Petition or Adoption needs to be amended following the initial filing, i.e the adoptee decides to change their name, or information provided on the original petition is incorrect, etc. This form will need to accompany a $20 petition fee, made payable to the Livingston County Juvenile Court. 

Michigan Department of Health & Human Services

• Adult Former Sibling Statement to Release Information to Adult Adoptee (DHS 1917)
• Release of Information to Adult Adoptee by Brother/Sister as Proxy for Deceased Parent (DHS 1918)
• Parent’s Consent/Denial to Release Information to Adult Adoptee (DHS 1919)
• Release of Information Authorization Adult Adoptee (DHS 1920)
• Request by Adult Adoptee for Identifying Information (DHS 1925)
• Release of Information from Michigan’s Adoption Records Pamphlet (DHS Pub 439)

State Court Administrative Office (SCAO) Forms

• SCAO-Approved Index of Adoptions Forms