Approved, SCAO
Original - Court 1st copy - for LEIN entry
2nd copy - Return to court 3rd copy - Tickler file OSM CODE: RMV
STATE OF MICHIGAN
JUDICIAL DISTRICT JUDICIAL CIRCUIT COUNTY PROBATE
ORI
CASE NO. REMOVAL OF ENTRY FROM LEIN
Court telephone no.
MI-
Court address
Effective date of order
Expiration date of order
Agency file no.
TO: Law enforcement agency and address
Defendant/Juvenile/Respondent name, address, and telephone no.
Date of birth
IT IS ORDERED: 1. The conditions requiring LEIN entry in this case or matter no longer exist. 2. The record of this entry shall be removed immediately from Law Enforcement Information Network (LEIN) files.
Date
Judge/District court magistrate
Bar no.
To the law enforcement agency: Immediately after receiving this form, remove entry in this case or matter from Law Enforcement Information Network (LEIN) files, complete the certification, and return the 2nd copy to the court. CERTIFICATION OF REMOVAL I certify that the LEIN entry in this case or matter has been removed from LEIN files.
Date Signature of law enforcement representative
MC 239 (3/06)
REMOVAL OF ENTRY FROM LEIN
MCL 764.15b, MCL 765.6b