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FOR THE THIRD JUDICIAL CIRCUIT OF MICHIGAN (Third Judicial Circuit of Michigan)

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THE CIRCUIT COURT
FOR THE THIRD JUDICIAL CIRCUIT OF MICHIGAN
FAMILY DIVISION – JUVENILE
Filing Instructions for Relative Adoptions
The mission of the Adoptions Unit is to help ensure permanently joined bonded family units through the timely
completion of parental rights’ termination, formal placement into approved homes, adoption finalization, and
the delivery of efficient post adoption services.
General Rules
1. The Third Judicial Circuit of Michigan, Family Division, processes adoption petitions for Wayne
County residents only.
2. The Court is open from 8:30 am to 4:30 pm. Appointments to initiate the adoption process will be
scheduled during these hours.
3. A relative is defined as anyone who is related by blood, adoption or marriage, within the fifth degree of
relationship. The relationship must be verified with certified birth certificates or certified death
certificates. (See documents section for more information.)
a. Relatives who adopt are not normally eligible for support subsidy through the State of Michigan.
Any Medicaid and/or ADC benefits the child is receiving may terminate upon entry of the Order
of Adoption. It is suggested you contact the agency where funds are received to determine if the
benefits will continue after the adoption has been granted.
4. If you are also a guardian of the child(ren), this is not the correct instruction packet. Please
request a Guardian Instruction packet.
5. Termination of parental rights of the biological parents must occur prior to an adoption being granted,
either on a voluntary or involuntary basis. This includes legal parents (an identified father who has
established paternity or who has been ordered to pay child support, and the biological mother not having
custody), the putative (alleged) father, or the unknown father.
6. Before an adoption can occur the child(ren) must be living in the petitioner’s home for at least six
months . Motions for exception may be requested and will be heard by the assigned adoption judge.
a. VOLUNTARY TERMINATION
i. If the biological parents are willing to consent to the adoption, an actual verification
through a conversation or mail correspondence has been ascertained, the parents may
consent to the adoption once the Petition for Adoption has been accepted and filed.
1. If either of the consenting parents resides in Wayne County, the parents must
appear at the Third Circuit Court of Michigan, Family Division, Juvenile Section,
1025 E. Forest Avenue, Detroit, MI 48207-1098, to execute a Consent to
Adoption by Parent before a Referee or Judge. (See the General Rules section of
these instructions for further information regarding when consents may be taken)
OR
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2. If either of the consenting parents resides outside of Wayne County, a Consent to
Adoption by Parent will be mailed to the parent, with instructions that the consent
must be executed in accordance with the laws of that county/state after the
Petition for Adoption is filed.
b. PARTIAL INVOLUNTARY TERMINATION – Putative Father (alleged) and, PARTIAL
VOLUNTARY TERMINATION – Mother Consents
i. The biological mother must be present at the initial screening and interview process if the
following conditions exist:
• The biological mother is willing to consent
• The child was born out of wedlock
AND
• The biological father is unknown or is unwilling to consent to the
adoption.
• There has been no support order entered ordering a father to
financially support the adoptee.
ii. The biological mother must file a Petition for Hearing to Identify Father to Determine or
Terminate His Rights when the Petition for Adoption is filed. (Other forms may be
necessary and will be determined on a case by cases basis.) A court hearing will then be
scheduled, at which time the biological mother must appear.
c. INVOLUNTARY TERMINATION OF ALL PARENTAL RIGHTS
i. If the following conditions exist an attorney must file a petition to terminate parental
rights at the Third Circuit Court of Michigan, Wayne County Clerk’s Office, Case
Initiation Unit, Room 301, Building B. The Petition for Termination must request
termination of parental rights as well as for the Court to Consent to the Adoption by the
relative:
• Mother’s location is unknown
• Mother is not willing to consent to the adoption
OR
• Mother is willing to consent to the adoption, or is deceased, and the
father has either established paternity or was ordered to pay support
and is not willing to consent to the adoption – OR his location is
unknown.
FOR AN ATTORNEY REFERRAL, PLEASE CALL (313) 961-3545
7. If an adoption is not granted, the termination of parental rights order will be set aside.
8. Prior to an adoption being granted a home investigation must be completed. A referral for the home
investigation will be made after the Petition for Adoption has been filed. You will be contacted by the
Michigan Children’s Law Center (MCLC) to set up a date for the home visit. You must discuss the
adoption process with the child(ren) being adopted, prior to the home investigation. All members of the
home must be available for the home investigation.
9. A subsequent office appointment may be necessary, should subsequent information be required, after the
Petition for Adoption has been filed.
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10. Biological parents (legal and putative) and adoptee(s) 14 years or older may consent to the adoption at
the Court. Consent hearings are heard daily at 8:30 am, before a Referee or Judge. A party wishing to
consent must appear in the Adoptions Unit, Room 414, fifteen minutes prior to the above time. If the
consenting parent is a minor (under the age of 18), a parent, or guardian must accompany the minor
parent to court. Consenting parents need to present some form of photo identification.
Qualifications for the Acceptance and Processing of the Adoption Petition
1. Petitioners and/or Adoptee must be residents of Wayne County. (Proof of residence is required)
2. Adoptee(s) 14 years and older must consent to the adoption. (See above in the General Rules section, #5
for more information regarding consents)
3. Petitioners must discuss the adoption process with the child/children to be adopted. This should be an
on-going process that starts before the Petition for Adoption is filed and continues, periodically, as the
child/children get(s) older.
4. The Court will not accept a Petition for Adoption if a petitioner has been convicted of any of the
following offenses:
a. Accosting, enticing or Soliciting Children for Immoral Purposes
b. Production of Child Pornographic Material
c. Criminal Sexual Conduct (I-IV)
d. Assault with Attempt to Commit Criminal Sexual Conduct
5. Upon Judicial Review, the Court may not grant a Petition for Adoption if any of the following
conditions exist:
a. Three, or more traffic convictions involving alcohol without verifiable proof of rehabilitation.
b. Any felony convictions within the past ten years.
c. Protective Services involvement with substantiated complaints within the last five years.
d. Support arrearages for children from previous relationships.
e. Pending criminal or child protective cases.
f. Outstanding warrants.
g. Health or mental problems that would restrict the petitioner from adopting.
6. If any concerns are noted during the screening process, a subsequent meeting and/or court hearing may
be required.
Fees
1. A one hundred sixty dollar ($160.00) filing fee, per adoptee, payable either by cash, money order, or
attorney check, must be paid at the time the Petition for Adoption is filed. Personal checks are not
accepted. Money orders and attorney checks should be made payable to the Wayne County Clerk.
2. For adoptees born in Michigan, a check or money order payable to the State of Michigan in the amount
of $50.00, to cover the processing and issuance of the new birth certificate must be paid. Additional
3
copies may be purchased for $16.00 per copy. For adoptees born outside the State of Michigan, the fee
for the new birth certificate varies from state to state.
3. The filing fee may be waived, if the petitioner is receiving public assistance or is on a fixed income.
Verifiable proof of income (i.e. current Medicaid Card for the family, pay stubs, income tax returns for
the previous year) must be submitted at the time of the office interview/appointment. The fee for the
new birth certificate cannot be waived.
Documents
1. The following documents, if applicable, are required to file the Petition for Adoption. Certified or true
copies of each of these documents are required. All foreign documents must be translated into English
and must be certified by a certified translator. Hospital “verifications” of birth, and photocopies (non
certified or true copies) of documents will not be accepted:
• Adoptees birth certificate.*
• Petitioners’ birth certificate.
• Petitioners’ marriage certificate to each other, as well as any previous marriage certificates for
either petitioner.
• All divorce decrees.
• Death certificate if a previous marriage ended because of the death of a spouse.
• Death certificate if the mother or father of the adoptee is deceased.*
• Acknowledgment of Paternity.*
• Order of Filiation or Support Order (when the mother and father of the child were not married).*
• All name change orders.
• Birth or death certificates showing relationship to the child if petitioners are relatives.
2. Other documents that are required, if applicable:
• If the petitioner(s) have children from a previous relationship a Friend of the Court
letter/summary detailing the status of child support, which must include payment and arrear
information*
• If child support has been ordered for the child(ren) being adopted, a Friend of the Court
letter/summary detailing the status of the child support, which must include payment arrear
information.*
• A letter must be sent to the biological parent notifying them of the intent to initiate the adoption
process and that their consent is needed. This letter must be sent certified. A copy of the letter
and the certified receipt card must be submitted to the court when filing the petition for adoption.
If the biological parent’s address is unknown, letters should be sent to any last known address, or
any known employers, relatives or friends. This must be done prior to requesting an
appointment to file the petition for adoption.*
• Clearances from any past criminal conviction or any alcohol related traffic violations that show
all fines and/or conditions have been satisfied.*
• If petitioner(s)/adoptee(s) are not U.S. citizens, the following documentation is required, if
applicable: valid Resident Alien Card, valid Visa from Immigration & Naturalization Services,
Naturalization documentation (certified/original).
• The petitioner(s), as well as other adults in the home are required to obtain and bring to the
appointment a Central Registry Clearance (child protective services). The clearance may be
4
requested at any local Department of Human Services (DHS) office, or at DHS South Central
Operations, 1801 E. Canfield, Detroit, MI 48207. NOTE: If the petitioner is a female,
clearances must also be completed on her current married name (if married), as well as her
maiden name, and any other previous names used during previous marriages.
• Medical clearances for all household members must be submitted at the time the Petition for
Adoption is filed. The clearances must be signed by a physician, and be dated within the past 12
months. Please see the attached health appraisal forms, which can be used for the adoption.
Electronic physician signatures will be accepted.*
• Three personal reference letters must be submitted at the time the Petition for Adoption is filed.
The references must be from non-relatives and from non-household members. Also, the letters
must be signed (original signatures), include contact information (address and telephone number)
and dated within the past 12 months.*
• Completed Adoption Report (MJC 1078) - attached.*
3. Proof of Residency:
• Valid Michigan Driver’s License or State I.D. for the petitioner(s).
*The Adoptions Unit will retain these documents.
Filing the Petition for Adoption
1. The Adoptions Unit is located on the 4
th
floor of Building B in the James H. Lincoln Hall of Juvenile
Justice. 1025 E. Forest Avenue, Detroit, MI 48207-1098.
2. The prospective adoptive parent(s) or attorney must call (313) 833-1880 to schedule an appointment to
initiate the adoption process.
3. If any petitioner requires a language interpreter, please make this request at the time you schedule the
appointment. The court will request an interpreter be present at the appointment on your behalf.
4. The attached Adoption Report (MJC 1078) must be completed prior to the scheduled office appointment.
5. The prospective adoptive parent(s) must be present at the scheduled appointment time, unless being
represented by an attorney.
• Should you retain an attorney to represent you, the attorney must review the “Attorney Instruction”
packet and prepare the required forms.
6. During the scheduled office appointment all of the required documents will be screened and
clearances/record checks will be completed in the following areas:
• LEIN system (criminal)
• Juvenile neglect/delinquency search
• Third Circuit Court of Michigan – Friend of the Court
7. Should all of the criteria be met, the Petition for Adoption will be prepared and the case will be processed in
a timely manner. Once termination of parental rights occurs there is a 21-day appeal period that must pass
prior to the adoption being finalized.
5
8. Should the Court approve the adoption the necessary information will be forwarded to the appropriate state
vital records department to create the new birth certificate.
Revised 01/2016
STATE OF MICHIGAN
THIRD CIRCUIT COURT
WAYNE COUNTY
ADOPTION REPORT
FILE NO.
Complete this entire form. Print or type the entire report. If certain areas do not apply, write or type N/A. If
more space is needed, use the back side of the form.
PETITIONERS INFORMATION
PETITIONER 1
PETITIONER 2
Name
(First, Middle, Last)
Birth Date
Social Security Number
Driver License Number
Address
City, State and Zip
Telephone Number
Petitioner’s Mother’s Name
and Date of Birth
(Parent of person adopting)
Petitioner’s Father’s Name
And Date of Birth
(Parent of person adopting)
Education Level
(Name of School & Grade
Completed)
Employer
Job Title
Current Yearly Income
Military History
(if yes, indicate
date of discharge)
Chronic or Terminal Illnesses
Date of Last Physical Exam
All Previous Marriages (if yes,
name of spouse(s)
Has support been ordered for
any other child from a
previous marriage or
relationship?
List all Criminal Convictions
4
Are there any pending
warrants for your arrest? (If
yes, list the district of the offense.)
List all Alcohol-Related
Traffic Convictions
Child Protective Services
Involvement
Did the biological/custodial
parent ever receive aid from
the State? If yes, when?
(Step-Parent adoptions only).
Have you previously been
approved to adopt a child?
If so, when? Also, if an
agency was involved, please
name the agency.
Are you currently, or have
you ever been a licensed
foster parent? If so, through
which agency?
(Child(ren) to be Adopted)
Name (First, Middle and Last)
Date of Birth
Social Security Number
Place of Birth
(city, county, state)
Length of time in home
Physical Health
Grade in School
Hobbies
Adoptee’s feelings regarding
the Adoption
Gender
(M or F )
& Race
Is the adoptee a Native
American Indian, if so, which
tribe.
Marital Status
(only applicable
for Adult Adoptions: single married,
divorced, separated or widowed).
5
ALL OTHER ADULTS CURRENTLY
RESIDING IN THE HOME
NAME
GENDER
(Male/Female)
RACE
MARITAL
STATUS
SOCIAL
SECURITY
NUMBER
DATE OF
BIRTH
ALL OTHER CHILDREN CURRENTLY RESIDING IN THE HOME
NAME
GENDER
(Male/Female)
RACE
SOCIAL SECURITY
NUMBER
DATE OF BIRTH
6
BIRTH PARENT INFORMATION
BIOLOGICAL FATHER
BIOLOGICAL MOTHER
Name
(First, Middle, Last)
Birth Date
Social Security Number
Address
City, State and Zip
Name of Mother of Biological
Parent
Name of Father of Biological
Parent
Siblings of Biological Parent
Education Level
(Name of School & Grade
Completed)
Physical Description
Current Employment
Current Marital Status
Name of Spouse
Names of other children from
previous or current
relationships/marriages
Chronic or Terminal Illnesses
Did the biological mother ever
receive aid from the State? If
yes, when?
N/A
Race
Falsification of any information on this form may result in the Petition for Adoption being denied.
Petitioner’s Signature
Date
Petitioner’s Signature (if two-parent adoption)
Date
MJC 1078 (01/2016)
7
PHYSICIAN’S REPORT FOR ADOPTIVE APPLICANT
Third Circuit Court of Michigan Re:
Family Division - Juvenile Section D
OB:
Detroit, MI 48207-1098
Dear Dr. ,
I hereby authorize you to release to
the Third Circuit Court of Michigan Family Division - Juvenile Section,
Adoptions Unit, information regarding my current and past physical and mental health.
Sincerely,
TO BE
COMPLETED BY THE PHYSICIAN
Date of physical examination Length of time know to physician
ANY HISTOR
Y OF:
Alcohol or Drug Dependency Diabetes
Cardiac Disease Mental Illness
Cancer Depression
Epilepsy Allergies
Diseases, injuries, surgeries, disabilities, or medical conditions not referred to above:
Remarks on h
ealth history:
CURR
ENT HEALTH STATUS:
Height
Blood
Pressure
Weight Vision
Heart Hearing
Lungs Abdomen
Medication currently prescribed; dosage and purpose:
Essential findings that are deviations from normal:
HIV informatio
n (optional):
Remarks on
medical examination (on the basis of the medical history and present physical condition,
please state any medical concerns you may have regarding this adoptive applicant):
Would you like to discuss this information with a Social Worker? Yes No
PLEASE PRINT OR TYPE
Physician’s Name
PH
YSICIAN’S SIGNATURE
Address
City, State, Zip Code Telephone Nu
mber
Adoptions Unit
1025 E. Forest Avenue
PHYSICIAN’S REPORT FOR A CHILD
Third Circuit Court of Michigan Re:
Family Division - Juvenile Section D
OB:
Detroit, MI 48207-1098
Dear Dr. ,
I hereby authorize you to release to the Third Circuit Court of Michigan Family Division - Juvenile Section,
Adoptions Unit,
information regarding my current and past physical and mental health.
Sincerely,
TO BE
COMPLETED BY THE PHYSICIAN
Date of physical examination Length of time know to physician
Diseases or illnesses kno
wn or treated by you in the last five years:
CURR
ENT HEALTH STATUS:
Height Weight
Medications c
urrently prescribed; dosage and purpose:
ANY HISTOR
Y OF:
Allergies Asthma
Other
Childhood Dis
eases:
Hospitalizations, operations, or injuries:
HIV information (optional):
IMMUNIZATIONS
DATES OF ORIGINAL SERIES
BOOSTER
S
DPT
Polio
MMR
HIB
Hepatitis B
Chicken Pox
Remarks on medical e
xamination (on the basis of the medical history and present physical condition, please state any
medical concerns you may have regarding this child):
Would you li
ke to discuss this information with a Social
Worker: Yes
No
PL
EASE PRINT OR TYPE
Physician’s Name
PHYSICIAN’S SIGNATURE
Address
City, State, Zip Code Telephone Nu
mber
1025 E. Forest Avenue
Adoptions Unit
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FOR THE THIRD JUDICIAL CIRCUIT OF MICHIGAN (Third Judicial Circuit of Michigan)

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Completed 29 July 2020

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