Approved, SCAO
JIS CODE: PSV
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
PROOF OF SERVICE/NONSERVICE
USE NOTE: This form is not to be used for proof of service of a summons or for publication
CASE NO. PETITION NO.
COUNTY
Court address
Court telephone no.
1. In the matter of
(name[s], alias[es], DOB)
Date of hearing: as follows: I served the above papers, copies of which are either attached or were ordinary certified ADDRESS registered mail addressed to
2. I served
(specify the titles of the papers served)
SERVICE BY MAIL
On
previously filed with the court, on the following person(s) by their last known address(es). NAME
PERSONAL SERVICE NAME
Copies of the above papers were served personally by me on the following person(s): PLACE OF SERVICE DATE AND TIME
NONSERVICE
After diligent inquiry, I have been unable to find and serve the following person(s): NAME REASON
I declare that this proof of service/nonservice has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Date JC 12b (9/06)
Signature
PROOF OF SERVICE/NONSERVICE
MCR 2.107(D), MCR 3.920(H)