MICHIGAN COURT FORMS June, 2017

1 MICHIGAN COURT FORMS June, 2017 Click here for up to date "MI COURT " FORMS @ Click here for the Home Page & More Options @ Circuit COURT FORMS CC 005 Order to Deposit Funds CC 008 motion for Consolidation CC 008a Order for Consolidation CC 011a Subpoena For Out-Of-State Case CC 011a for Word 97 Subpoena For Out-Of-State Case - For use with Word 97 CC 018 Order to Release Funds CC 020a Order regarding Suspension of Prisoner Fees/Costs CC 058 Order to Show Cause Why Appeal Should Not Be Dismissed CC 059 Notice of Intent to Dismiss Appeal CC 061 Order Dismissing Appeal CC 071 Record Production Checklist for COURT of Appeals CC 078 Dismissal of Prisoner Civil Action, Frivolous Action CC 079 Claim of Appeal on Application for Concealed Pistol License CC 080 Order Following Appeal on Application for Concealed Pistol License CC 088 Order Revoking Release and Forfeiting Bond, Notice of Intent to Enter Judgment (Domestic Relations) CC 089 Judgment After Bond Forfeiture (Domestic Relations) CC 115 Notice of Foreclosure Sale CC 116 Clerk's Certificate of Sale of Real Estate Pursuant to Judgment CC 117 County Clerk's Report of Sale CC 219b Judgment of Sentence Commitment to Department of Corrections CC 236 Order Committing Juvenile to Department of Health and Human Services CC 243a Order of Probation (Felony)

2 , Part 1 & 2 CC 257 motion for Relief from Judgment CC 261 Waiver of Arraignment and Election to Stand Mute or Enter Not Guilty Plea CC 265 Notice of Right to Appellate Review and Request for Appointment of Attorney CC 268 Order regarding Driver License Restoration CC 269 Order regarding Driver License Restoration After Review of the Record 1/1/92 Through 9/30/99 CC 291 Advice of Rights (Circuit COURT Plea) CC 293 Affidavit Concerning Financial Status Leave to Appeal Granted by Supreme COURT CC 295 Appeal of Suspension, Revocation, or Denial of Driver s License CC 296 Petition for Review of Drivers License Denial, Restriction, or Suspension for Arrests or Actions Before 10/1/99 CC 297 Petition for Review of Drivers License Denial, Restriction, or Suspension for Arrests or Actions After 10/1/99 CC 298 Application for Leave to Appeal and CC 299 Order on Application for Leave to Appeal CC 325 Request for Hearing on a motion CC 327 Order CC-375 Oakland Co Oakland County - Petition for Personal Protection Order (Domestic Relationship) CC 375 Petition for Personal Protection Order (Domestic Relationship) CC 375M Petition for Personal Protection Order Against a Minor CC 376 Personal Protection Order (Domestic Relationship)

3 ( Ex Parte) CC 376a Personal Protection Order ( Ex Parte) Page 2 CC 376M Personal Protection Order Against a Minor CC-377 Oakland Co Oakland County - Petition for Personal Protection Order Against Stalking (Non Domestic) CC 377 Petition for Personal Protection Order Against Stalking (Nondomestic) CC 377M Petition for Personal Protection Order Against a Minor (Nondomestic) CC 378 motion and Order to Dismiss Action for Personal Protection Order CC 379 motion to Modify, Extend or Terminate Personal Protection Order CC-380 Oakland Co Oakland County - Personal Protection Order (Nondomestic) CC 380 Personal Protection Order (Nondomestic) CC 380M Personal Protection Order Against a Minor (Nondomestic) CC-381 Oakland Co Oakland County - Notice of Hearing on motion for Personal Protection Order CC 381 Notice of Hearing on Petition for Personal Protection Order CC 382 motion and Order to Show Cause for Violating Valid Personal/Foreign Protection Order CC 382a Order After Hearing on Show Cause for Violating Valid Personal/Foreign Protection Order CC 383 Order Denying or Dismissing Petition for Personal Protection Order CC 384 Order After Hearing on Violation of Personal Protection Order CC 385 Order on motion to Modify, Extend, Terminate Personal Protection Order CC 386 Proof Of Service/Oral Notice regarding Personal Protection Order CC 387 Order Vacating Conviction and Entering New Disposition CC 388 Notice of Registration of Out-of-State Child-Custody Determination (UCCJEA)

4 CC 389 Order regarding Registration of Out-of-State Child-Custody Determination (UCCJEA) CC 395 Petition for Personal Protection Order (Nondomestic Sexual Assault) CC 395M Petition for Personal Protection Order Against a Minor (Nondomestic Sexual Assault) CC 396 Personal Protection Order (Nondomestic Sexual Assault) CC 396M Personal Protection Order Against a Minor (Nondomestic Sexual Assault) CC 400 MAACS Statement of Service And Order for Payment of COURT Appointed Counsel, Page 1 CC 401 MAACS Statement of Service And Order for Payment of COURT Appointed Counsel, Page 2 CC 402 Order regarding Appointment of Appellate Counsel and Transcript CC 403 Claim of Appeal and Order Appointing Counsel CC 404 Notice to Prisoner on Application for Leave to Appeal Decision of Parole Board CC 414 Plea Agreement / Sentence Agreement CC 434 Order For Genetic Testing (Revocation of Paternity Act)

5 CC 435 Complaint / motion and Affidavit to Revoke Acknowledgment of Parentage CC 436 Order regarding Request to Revoke Acknowledgment of Parentage CC 437 motion to Set Aside Order of Filiation CC 438 Order on motion to Set Aside Order of Filiation The following 9 FORMS no longer carry the SCAO Approval CC 415 Complaint for Divorce, Page 1 CC 417a Custody/Visitation/Support Order, Page 1 CC 417b Custody/Visitation/Support Order, Page 2 CC 418a Spousal Support Order (Page 1 of 2) CC 418b Spousal Support Order (Page 2 of 2) CC 427a Judgment of Divorce (Page 1 of 2) CC 427b Judgment of Divorce (Page 2 of 2) CC 427c Judgment of Divorce (Final Page) CC 428 Default Application and Non-Military Affidavit and Entry (Domestic Relations) District COURT FORMS CIA 01 Notice to Appear, Civil Infraction CIA 02 Judgment, Civil Infraction CIA 03 14 Day Notice, Civil Infraction CIA 04 motion to Set Aside Default Judgment and Order, Traffic/Civil Infraction CIA 05 Claim of Appeal of Right, Traffic/Civil Infraction CIA 07 Default Judgment.

6 Civil Infraction DC 040 Notice of Seizure of Personal Property Subject to Forfeiture Without Process and Order DC 041 motion and Order to Seize Personal Property Subject to Forfeiture DC 042 Application and Ex Parte Order to File Lien on Real Property Subject to Forfeiture DC 043 Notice of Seizure and Intent to Forfeit and Dispose of Property DC 044 Order for Return of Property or Discharge of Lien in forfeiture Proceedings DC 045 Notice of Intent to Forfeit and Dispose of Property DC 046 Order Following Forfeiture Proceedings DC 047 Order of Distribution in Forfeiture Proceedings DC 053 Appeal Worksheet for Application for Leave to Appeal DC 054 Appeal Worksheet for Claim of Appeal of Right DC 084 Affidavit and Claim, Small Claims DC 085 Judgment, Small Claims DC 086 Demand and Order for Removal, Small Claims DC 090 Petition regarding Impoundment of Motor Vehicle or Seizure of Motorcycle DC 091 Order regarding Impoundment of Motor Vehicle or Seizure of Motorcycle DC 099b motion to Set Aside Default Judgment (Ex Parte Order to Stay Eviction) (Landlord-Tenant) DC 099c motion and Affidavit to Set Aside Default Money Judgment (Landlord-Tenant) DC 100a Demand for Possession, Non-Payment of Rent, Landlord-Tenant DC 100b Demand for Possession, Damage/Health Hazard to Property, Landlord-Tenant DC 100c Notice to Quit to Recover Possession of Property, Landlord-Tenant DC 100d Demand for Possession, Termination of Tenancy, Mobile Home Park-Mobile Home Owner (Just-Cause Termination)

7 DC 100e Demand For Possession Termination of Tenancy Due to Unlawful Drug Activity on Premises DC 101 Forfeiture Notice, Land Contract DC 102a Complaint, Non-Payment of Rent, Landlord-Tenant DC 102b Complaint, Damage/Health Hazard to Property, Landlord-Tenant DC 102c Complaint to Recover Possession of Property DC 102d Complaint, Termination of Tenancy, Mobile Home Park-Mobile Home Owner (Just-Cause Termination) DC 103 Complaint for Possession After Land Contract Forfeiture DC 104 Summons, Landlord-Tenant/Land Contract DC 105 Judgment, Landlord-Tenant 60-DC-201 60th District COURT - Judgment - Landlord - Tenant DC 105a Judgment, Termination of Tenancy, Mobile Home Park-Mobile Home Owner (Just-Cause Termination) DC 106 Judgment of Possession After Land Contract Forfeiture DC 107 Application and Order of Eviction, Landlord/Tenant-Land Contract DC 109 motion and Order for Escrow, Landlord-Tenant / Land Contract DC 110 Order to Release Escrow, Landlord-Tenant DC 111a Answer, Nonpayment of Rent, Landlord-Tenant DC 111b Answer, Damage/Health Hazard to Property, Landlord-Tenant DC 111c Answer to Complaint to Recover Possession of Property DC 111d Answer, Termination of Tenancy, Mobile Home Park-Mobile Home Owner (Just-Cause Termination)

8 DC 118 Complaint and Summons regarding Dangerous Animal DC 119 Order regarding Dangerous Animal DC 213 Advice of Rights and Plea Information DC 215 Affidavit of Incorrect Address DC 223 Plea by Mail DC 225 Complaint, Misdemeanor - Warrant, Misdemeanor DC 226 Warrant, Misdemeanor, Traffic/Non-traffic DC 243 Order of Probation (Misdemeanor) (Part 1 & 2) DC 250 Felony Register of Actions DC 251 Misdemeanor Register of Actions DC 252 Civil Register of Actions DC 255 Notice to Prosecuting Official (Victim's Rights Act) Friend of the COURT FORMS FOC 01a Friend of the COURT Grievance FOC 01b Grievance Response FOC 02 motion and Order to Show Cause for Contempt (Support) FOC 02a motion and Order to Show Cause for Contempt (Medical) FOC 04 Cash Performance Bond FOC 05 Order regarding Income Withholding FOC 05a Income Withholding Order - Berrien County FOC 05k Income Withholding Order - Kalamazoo County FOC 05Z Notice of Mandatory Income Withholding (Oakland County) FOC 06 Support Enforcement Order, Pages 1 and 2 FOC 06a Supervision Order (Support Enforcement) FOC 07 Notice of Hearing FOC 10 Group-2017 Group of FORMS - Uniform Child Support Order With Friend of COURT Services Group of FORMS that will populate automatically from Master Information Sheet Includes the following FORMS : FOC 10/52, 10b, 23 and 100 FOC 10a Group-2017 Group of FORMS - Uniform Child Support Order Without Friend of COURT Services Group of FORMS that will populate automatically from Master Information Sheet Includes the following FORMS .

9 FOC 10a/52a, 10c, 23 and 100 FOC 10-52-2017 Uniform Child Support Order MUST USE AFTER 1/1/17-NOT BEFORE FOC 10a-52a-2017 Uniform Child Support Order, No Friend of COURT Services MUST USE AFTER 1/1/17-NOT BEFORE FOC 10b Uniform Spousal Support Order FOC 10c Uniform Spousal Support Order, No Friend of COURT Services FOC 10d-2017 Uniform Child Support Order Deviation Addendum MUST USE AFTER 1/1/17-NOT BEFORE FOC 11 Replaced by FedIncWh Form (next line down) FedIncWh Federal Income Withholding Form FOC 11-Macomb Co Notice of Income Withholding (As of June, 2003, this is the form Macomb County will still accept you can enter figures on this form.) FOC 12 Referral Order FOC 13 Request for Health-Care Expense Payment FOC 13a Complaint for Enforcement of Health Care Expense Payment FOC 14 Bench Warrant FOC 16 21-Day Notice to Alleged Violator of Custody or Parenting Time Provisions FOC 17 Friend of the COURT Annual Statutory Review FOC 17W Affidavit and Ex Parte Order - Washtenaw County FOC 18 Publication and Notice of Friend of the COURT Annual Statutory Review FOC 18W Ex Parte Order for Temporary Possession of Children or Temporary Support of Children, and Referral -Washtenaw Co FOC 19 motion and Order to Show Cause for Contempt (Custody/Parenting Time)

10 FOC 21 motion and Order for Disclosure of Income and Health Insurance Information FOC 22 Employer's Disclosure of Health Insurance and/or Income Information FOC 22b Employment Status Disclosure FOC 23 Verified Statement and Application for IV-D Services FOC 23K Verified Statement and IV-D Application - Kalamazoo County FOC-23-Midland Verified Statement Midland County FOC 23 Oak Verified Statement - Oakland County FOC 092W Verified Statement - Washtenaw County FOC 23w Verified Statement - Wayne County FOC 24 Petition/Stipulation for Transferring Case (Postjudgment) FOC 25 Order Changing Venue and Transferring Case (Postjudgment) FOC 29 Order regarding change of domicile / legal residence FOC 30 Notice of Registration of Out of State Support Order FOC 30a Order Confirming Registration of Out-of-State Support Order (UIFSA) FOC 32 Washtenaw County Friend of the COURT Questionnaire and Child-Care Verification FOC 39-oak Oakland County Friend of the COURT Questionnaire FOC 39 Friend of t