In the realm of personal records and legal documentation, the Department of Human Services (DHS) Form stands out as a crucial document, especially for those touched by the process of adoption in Michigan. This form facilitates a deeply personal yet legal avenue for adoptees to obtain information about their biological origins, specifically when a biological parent has passed away. By enabling a biological brother or sister to act as a proxy for the deceased parent, the form represents a structured yet sensitive approach to information sharing, reinforcing the rights of adult adoptees to access their personal history. It stipulates the need for detailed information about the adoptee and the deceased biological parent, along with the consent of the biological sibling. The form also underscores the importance of including a death certificate of the deceased parent to validate the request. Mandated by Michigan Complied Laws Annotated 710.27, it embodies a legal framework designed to respect the delicate balance between privacy and the adoptee's right to know their origins. The DHS form, while openly acknowledging the voluntary nature of this consent, operates under a system of transparent and non-discriminatory practices, as reflected in its encouragement of inclusive assistance for individuals with disabilities under the Americans with Disabilities Act. This document, therefore, is more than a mere form; it is a gateway to potentially life-altering discoveries for adoptees, grounded in compassion, legality, and the acknowledgment of one's fundamental right to know where they come from.
| Question | Answer |
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| Form Name | Form Dhs 1918 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | FIA1918_10573_7 change in central registry clearance request michigan dhs form |
For Office Use Only
Birth Date
Adoptee’s Birth Name (Last, First, Middle)
RELEASE OF INFORMATION TO ADULT ADOPTEE BY
BROTHER/SISTER AS PROXY FOR DECEASED PARENT
Michigan Department of Human Services
CENTRAL ADOPTION REGISTRY
INSTRUCTIONS: |
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• The address of the Central Adoption Registry is: |
• A separate statement must be completed for each |
MICHIGAN DEPARTMENT OF HUMAN SERVICES |
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child/adoptee. |
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CENTRAL ADOPTION REGISTRY |
• This form MUST be accompanied by a copy of the |
PO BOX 30037 |
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LANSING MI 48909 |
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death certificate of the deceased parent. |
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• Send a new statement to the Central Adoption |
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Registry if your name or address changes. |
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I state that I am the biological |
BROTHER |
SISTER of the child described below. Our |
biological parent is deceased and the death certificate is enclosed. In accordance with Michigan Complied Laws Annotated 710.27, I hereby give consent to the release of our deceased parent’s name to this child when he/she is 18 years of age or older.
INFORMATION ABOUT THE CHILD:
Child’s Full Name at Birth (Last, First, Middle) |
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Child’s Birth Date (Month/Day/Year) |
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Child’s City of Birth |
Child’s County of Birth |
Child’s State of Birth |
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INFORMATION ABOUT DECEASED BIOLOGICAL PARENT:
Deceased Parent’s Name When Parental Rights Were Released or Terminated (Last, First, Middle)
INFORMATION ON BIOLOGICAL BROTHER/SISTER WHO IS CONSENTING TO RELEASE OF INFORMATION:
My Current Name (Last, First, Middle) |
My Birth Date (Mo., Day, Yr.) |
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My Name at Time Parental Rights Were Terminated, If Different (Last, First, Middle)
Address (Street Number and Name) |
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Apartment or Lot Number |
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City |
State |
Zip Code |
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Telephone Number |
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Brother/Sister Signature |
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Date |
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Department of Human Services (DHS) will not discriminate against |
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any individual or group because of race, sex, religion, age, national |
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AUTHORITY: MCLA 710.68. |
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origin, color, height, weight, marital status, political beliefs or |
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COMPLETION: Voluntary. |
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disability. If you need help with reading, writing, hearing, etc., under |
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PENALTY: None |
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the Americans with Disabilities Act, you are invited to make your |
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needs known to a DHS office in your area. |
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DISTRIBUTION: ORIGINAL - Michigan Department of Human Services |
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Central Adoption Registry |
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P.O. Box 30037 |
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Lansing, Michigan 48909 |
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COPY - Keep for your records. |
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