Approved, SCAO
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
Court address
MOTION AND AUTHORIZATION/DENIAL
CASE NO. PETITION NO.
Court telephone no.
1. In the matter of
(name(s), alias(es), DOB)
MOTION 2. The names and addresses of parents, guardians, or legal custodians are:
Father Mother Guardian/Legal custodian Address Address Address
3. I request a transfer of this case to the formal calendar review. hearing regarding the agency's notice of intent to return the child home. review the initial services plan and/or custody or placement order.
State reasons below as appropriate
rehearing.
adjournment.
I declare that this motion has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Agency/Address City, state, and zip Telephone no.
Signature Name (type or print)
Date
AUTHORIZATION/DENIAL 4. Transfer is authorized and hearing on the petition of
Date
is set for at m. at
Time Location
. is authorized and .
Location
Date
5.
Review
Rehearing
Date
Adjournment
Hearing on agency's intent to return child home at
Time
hearing is set for 6. Transfer Review Rehearing
m. at is denied.
Adjournment
Date
Judge/Referee
Bar no.
Do not write below this line - For court use only
JC 15 (6/03)
MOTION AND AUTHORIZATION / DENIAL
MCL 712A.13a(12), MCL 712A.17, MCL 712A.18d, MCL 712A.19(10), MCL 712A.21, MCR 3.923(G), MCR 3.932(C)(8), MCR 3.942(A), MCR 3.945(A), MCR 3.966, MCR 3.972(A), MCR 3.975(H), MCR 3.992(A)