Approved, SCAO
JIS CODE: MCD
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
Court address
MOTION AND ORDER FOR MODIFICATION OR CANCELLATION OF RESTITUTION OWED
CASE NO. PETITION NO.
Court telephone no.
1. In the matter of
name(s), alias(es), DOB
MOTION 2. I have been ordered to pay restitution to the victim in the amount of $ .
3. Payment of the amount due as previously ordered is imposing a manifest hardship on me for the following reasons: 4. I am the juvenile and I request that the court modify the method of payment as follows:
5. I am the juvenile's parent and I request the court to a. modify the method of payment as follows:
b. cancel the balance of restitution I have been ordered to pay because of the following hardship:
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.
Signature of person making motion Name (type or print)
Date
Address City, state, and zip Telephone no.
ORDER Date of Hearing: Judge/Referee:
Bar no.
6. The court finds that the prior order of restitution imposes the following hardship(s):
IT IS ORDERED: 7. The method of payment by the
juvenile parent of the juvenile
is modified as follows:
8. The obligation of the parent to pay restitution is cancelled as to the amount of $ 9. The motion is denied.
Date Judge
.
Do not write below this line - For court use only
JC 54 (11/05)
MOTION AND ORDER FOR MODIFICATION OR CANCELLATION OF RESTITUTION OWED
MCL 780.794