Approved, SCAO
Original - Circuit court 1st copy - District/Municipal court
2nd copy - Appellee 3rd copy - Appellant
STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
Court address
APPLICATION FOR LEAVE TO APPEAL AND NOTICE OF HEARING
CASE NO. DISTRICT MUNICIPAL
Court telephone no.
Plaintiff's name, address, and telephone no.
Appellant Appellee v
Defendant's name, address, and telephone no.
Appellant Appellee
Plaintiff's attorney, bar no., address, and telephone no.
Defendant's attorney, bar no., address, and telephone no.
1.
Name Date
, requests leave to appeal an order or a judgment entered on in the
Court name and number or county Bar no.
Court of the State of Michigan, .
by Hon. 2. a. b. a. b.
No appeal of right exists. The time for taking an appeal under MCR 7.101(B)(1) has expired. 3. This application for leave is being filed within 21 days of the order or judgment date and, therefore, is timely. This application for leave is being filed more than 21 days after the order or judgment date, but not more than 6 months thereafter. (The affidavit explaining delay on the other side of this form has been completed.) 4. The grounds for appeal are: (Attach additional pages as needed.)
5. The proceedings in the district/municipal court were: (Describe the proceedings.)
Date
Appellant/Attorney signature
NOTICE OF HEARING A hearing is scheduled on the appellant's request for leave to appeal on at
Location Date
at
Time Bar no.
before Hon.
.
CERTIFICATE OF MAILING I certify that on this date I served a copy of this application for leave to appeal and notice of hearing on the appellee or his/her attorney by first-class mail addressed to his/her last-known address as defined in MCR 2.107(C)(3).
Date Appellant signature
CC 298 (3/08)
APPLICATION FOR LEAVE TO APPEAL AND NOTICE OF HEARING
MCR 7.103
AFFIDAVIT EXPLAINING DELAY This application is being filed more than 21 days but not more than 6 months after the entry of the order or judgment being appealed because: (Explain in detail the reasons for the delay in filing.)
Appellant/Attorney signature
Subscribed and sworn to before me on
Date
, Signature:
County, Michigan.
My commission expires:
Date
Notary public, State of Michigan, County of