Approved, SCAO
JIS CODE: OBJ
STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION
OBJECTION TO ADMINISTRATIVE ADMISSION (INDIVIDUAL WITH DEVELOPMENTAL DISABILITY)
FILE NO.
In the matter of 1. I object to the administrative admission of
Name
, an individual with a developmental disability and request the
court to schedule a hearing on this objection. This objection is made within 30 days after the admission of the resident. after the first objection or six months after a prior objection.
Date
Signature
2. The person filing this objection is the resident. I am age 13 or older.
Name Address Telephone no. Relationship or reason interested in resident City State Zip
3. The resident was administratively admitted to on
Date Address
Name of center Name City State Zip
upon the application of
,
,
Telephone no.
who is the resident's
parent.
guardian.
person in loco parentis.
Do not write below this line - For court use only
MCL 330.1511 PCM 203 (9/07)
OBJECTION TO ADMINISTRATIVE ADMISSION (INDIVIDUAL WITH DEVELOPMENTAL DISABILITY)