Skip to content
LitigationForms
PCA 355

Out-of-Court Consent to Direct Placement Adoption by Parent

Michigan · Michigan State Court Administrative Office · Effective September 1, 2023

This form is a legal document where a parent gives up their parental rights to a child in exchange for the child being placed for adoption without going through a formal court hearing. It requires the parent to sign statements showing they understand what they are giving up.

The court describes it as: Court rule / statute: MCL 710.44

Open the official PDFfrom Michigan State Court Administrative Office

Where this fits in a case

Start a case

Stage: Start a case

This form is used when a parent is consenting to the direct placement adoption of their child outside of a formal court proceeding. It must be signed at least 72 hours after the child is born.

Either party may file.

Common questions

Who signs this form?
The parent or guardian of the child signs this form. If the parent is a minor, the parent's guardian or guardian ad litem also signs it.
What does signing this form mean?
Signing this means the parent is giving up all their parental rights. The parent acknowledges that this termination of rights is permanent unless the court allows them to take it back.
Can the parent change their mind later?
The form explains that the parent can submit a written request to try and get the out-of-court consent revoked, but they must appear before the court for that to be considered.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect September 1, 2023.

Related forms

  • CCFD 24

    Petition (Collaborative Law Process)

    This form is a Petition used to start a case in the Family Division court when the parties plan to use a collaborative law process. It asks the court to confirm details about the parties, their residency, and the reasons for the case.

    MandatoryFillable PDF
  • CCFD 25

    Petition (Consent Judgment)

    This form is a Petition for a Consent Judgment used when two parties agree on the terms of a court decision. It asks the court to approve an agreement that will become a final judgment.

    MandatoryFillable PDF
  • FOC 13a

    Complaint and Notice for Health-Care Expense Payment

    This form is used to ask the friend of the court to help enforce payments for health-care expenses. It requires the person filing to state that they have already asked the person who owes the money (the obligor) for payment and that the information provided is true.

    Fillable PDF
  • MC 21

    Confidential Case Inventory (Domestic Relations and Juvenile Code)

    This form asks people to list any family or tribal court cases that are currently happening or have already been finished for the people involved in the current case. It requires listing details about other courts and whether any support or parenting time orders are active.

    MandatoryFillable PDF
  • MC 281b

    Domestic Relations Mediator Application

    This form is an application to become a domestic relations mediator. It asks the applicant to provide personal details and prove they have met specific training and experience requirements set by the court.

    Fillable PDF
  • PC 100

    Petition for Emancipation, Affidavit, and Waiver of Notice

    This form is a request to the court asking the judge to declare that a minor is legally emancipated. It asks the minor to confirm they are old enough, can handle their own money and life, and understand the laws about emancipation.

    Fillable PDF
  • PC 101

    Order Following Hearing on Petition for Emancipation

    This form is an official court document used to record a judge's decision after a hearing about a minor's request to be legally emancipated. It states whether the court finds the necessary conditions for emancipation have been met and what the final order is.

    Fillable PDF
  • PC 102

    Petition to Rescind Order of Emancipation

    This form is a request to the court to cancel a previous order that declared a minor legally emancipated. The person filing this form must state why the order should be canceled, such as if the minor now has no money for support or if the family relationship has resumed.

    Fillable PDF