Free dc42.pmd - Michigan

Approved, SCAO

Original - Court 1st copy - Plaintiff/Attorney

2nd copy - Defendant/Attorney 3rd copy - Extra

STATE OF MICHIGAN JUDICIAL DISTRICT

APPLICATION AND EX PARTE ORDER TO FILE LIEN ON REAL PROPERTY SUBJECT TO FORFEITURE

CASE NO.

Court address

Court telephone no.

The People of the State of Michigan The People of In the matter of v

Defendant name, address, and telephone no.

APPLICATION AND AFFIDAVIT attorney general prosecuting attorney city/township attorney for
Description

1. I am the

and I state

there is probable cause to believe the following real property,

, is subject to forfeiture based upon the following reasons:

. 2. I REQUEST an order authorizing the filing of a lien notice because it is believed a. the property is the proceeds of a crime. b. the property is the substituted proceeds of a crime.
Date Signature Name (type or print)

Subscribed and sworn to before me on My commission expires:

Date

, Signature:
Notary public

County, Michigan.

Notary public, State of Michigan, County of ORDER 3. THE COURT FINDS there is is not probable cause to believe the real property described above is the proceeds of a crime or the substituted proceeds of a crime and is subject to forfeiture. IT IS ORDERED: 4. A lien notice may be filed against the real property. 5. The application is denied.
Date Judge Bar no.

MCL 600.4703(3) DC 42 (3/09)

APPLICATION AND EX PARTE ORDER TO FILE LIEN ON REAL PROPERTY SUBJECT TO FORFEITURE