DHS-5308, Verification of Court ... - State of Michigan
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|VERIFICATION OF COURT ACCEPTANCE OF ADOPTION PETITION |
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|This form is verifying that a complete adoption petition and the required appropriate supporting documents have been accepted by the court for the following child: |
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|Child’s Name | |
|Child’s Date of Birth | |
|Adoptive Parent(s) | |
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|Adoption Agency Name | |
|Adoption Agency Address | |
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|Adoption Worker’s Name | |
|County Court | |
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|By my signature, I verify that the adoption petition and the required appropriate supporting documents were filed with the court for the above-named child (date).|
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|Adoption Worker Signature | |Date |
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|By my signature, I verify that the adoption petition and the required appropriate supporting documents were filed with the court for the above-named child and accepted |
|by the court on (date). |
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|Court Representative Signature | |Title | |Date |
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|The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, |
|color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability. |
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State of Michigan
department of HEALTH AND human services
Lansing
GRETCHEN WHITMER
governor
ROBERT GORDON
director
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