Approved, SCAO
JIS CODE: NDC
STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION
FILE NO. NOTICE OF DISALLOWANCE OF CLAIM
Estate of TO:
Claimant name and address
Your written statement of claim dated in whole. in part as to
for $
is disallowed
. The entire claim portion of the claim that has been disallowed will be forever barred unless you start a civil action by filing a complaint against the fiduciary. Your complaint must be filed with the appropriate district, circuit, or probate court not later than 63 days after the mailing or delivery of this notice.
Date Signature of attorney Name of attorney (type or print) Address City, state, zip Telephone no. Bar no. Signature of fiduciary Name of fiduciary (type or print) Address City, state, zip Telephone no.
PROOF OF SERVICE I certify that on
Date
I served a copy of this notice on the claimant by
first-class mail at the address stated above. delivering it personally to the claimant. I declare under the penalties of perjury that this proof of service has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Date Signature of fiduciary/attorney
Do not write below this line - For court use only
PC 580 (9/07)
NOTICE OF DISALLOWANCE OF CLAIM
MCL 700.3806, MCL 700.5429, MCL 700.7507