Approved, SCAO
Original - Court 1st copy - Prosecutor 2nd copy - Defendant
STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT
District Court ORI: MI-
CASE NO. INFORMATION FELONY Amended
Circuit Court ORI: MI-
DISTRICT CIRCUIT
Defendant's name and address
Victim or complainant Complaining witness Date: On or about
THE PEOPLE OF THE STATE OF MICHIGAN
Co-defendant(s) City/Twp./Village Police agency report no. Witnesses
v
County in Michigan Charge
Defendant CTN
Defendant SID Maximum penalty
Defendant DOB
Oper./Chauf. CDL
Vehicle Type Defendant DLN
STATE OF MICHIGAN, COUNTY OF IN THE NAME OF THE PEOPLE OF THE STATE OF MICHIGAN: The prosecuting attorney for this County appears before the court and informs the court that on the date and at the location described, the defendant:
and against the peace and dignity of the State of Michigan. Prosecuting Attorney
Date
By:
MC 200a (7/05)
FELONY SET (3 part Information Set only)
MCL 764.1 et seq., MCL 766.1 et seq., MCL 767.1 et seq., MCR 6.112(D)