Numerical Index of Approved District Court Forms

Name	Date	Title	Citation	Previous Versions
cia01	3/08	Notice to Appear, Civil Infraction
cia02	6/19	Judgment, Civil Infraction	MCR 4.101(B), 50 USC 3931	(3/11) version can be used until stock is depleted
cia03	6/18	14-Day Notice, Civil Infraction		(3/16) version can be used until 12/31/2018
cia04	3/15	Motion to Set Aside Default Judgment and Order, Civil Infraction	MCR 4.101(D)	(3/09) version can be used until stock is depleted
cia05	3/08	Claim of Appeal of Right/Request to Withdraw Admission and Order, Civil Infraction	MCR 4.101(G), (H)(3)
cia07	3/16	Default Judgment, Civil Infraction	MCR 1.110, MCR 4.101(B)	(3/15) version can be used until stock is depleted
dc40	3/15	Notice of Seizure of Personal Property Subject to Forfeiture without Process and Order	MCL 600.4703(2)	(3/09) version can be used until 6/30/15
dc41	3/09	Motion and Order to Seize Personal Property Subject to Forfeiture	MCL 600.4703(5)
dc42	3/15	Application and Ex Parte Order to File Lien on Real Property Subject to Forfeiture	MCL 600.4703(3)	(3/09) version can be used until 6/30/15
dc43	3/15	Notice of Seizure and Intent to Forfeit and Dispose of Property	MCL 600.4704	(3/09) version can be used with hand correction
dc44	3/15	Order for Return of Property or Discharge of Lien in Forfeiture Proceedings	MCL 600.4705, MCL 600.4706, MCL 600.4706a	(3/09) version can be used with hand correction
dc45	3/15	Notice of Intent to Forfeit and Dispose of Property	MCL 600.4707	(3/09) version can be used with hand correction
dc46	3/15	Order Following Forfeiture Proceedings	MCL 600.4707	(3/09) version can be used until 6/30/15
dc47	3/09	Order of Distribution in Forfeiture Proceedings	MCL 600.4708
dc53	6/18	Appeal Worksheet for Application for Leave to Appeal		(3/15) version can be used until 12/31/2018
dc54	6/18	Appeal Worksheet for Claim of Appeal of Right		(3/13) version can be used until 12/31/2018
dc84	6/19	Affidavit and Claim, Small Claims	MCL 600.8401 et seq., MCR 4.302, MCR 4.303, 50 USC App 3931	(12/17) version can be used until stock is depleted
dci84	6/19	Collecting Your Money from a Small Claims Judgment	MCL 600.8409(2)	(10/12) version can be used until stock is depleted
dc85	6/19	Judgment/Dismissal, Small Claims	MCL 600.8401 et seq., MCR 2.620, MCR 4.305, 50 USC 3931	(6/18) version can be used until 12/31/2019
dc86	6/19	Demand and Order for Removal, Small Claims	MCL 600.8401 et seq., MCR 4.306	(3/16) version can be used until 12/31/2019
dc90	11/19	Petition Regarding Impoundment of Motor Vehicle	MCL 257.252a, MCL 257.252f,	(3/11) version can be used until 12/31/2019
dc90a	11/19	Petition Regarding Seizure of Motorcycle	MCL 257.230a	NEW FORM
dc91	11/19	Order Regarding Impoundment of Motor Vehicle	MCL 257.252a, MCL 257.252f	(3/10) version can be used until 12/31/2019
dc91a	11/19	Order Regarding Seizure of Motorcycle	MCL 257.230a	NEW FORM
dc99b	6/17	Motion to Set Aside Default Possession Judgment, Landlord/Tenant	MCR 4.201(M)	(3/15) version can be used until stock is depleted
dc99c	3/15	Motion and Affidavit to Set Aside Default Money Judgment (Landlord/Tenant)	MCR 4.201(M)
dc100a	6/19	Demand for Possession, Nonpayment of Rent, Landlord-Tenant	MCL 600.5714(1)(a), MCL 600.5716, MCL 600.5718, MCL 600.5775(2)(f)	(3/16) version can be used until stock is depleted
dc100anoinstructions	6/19	Demand for Possession, Nonpayment of Rent,Landlord-Tenant (two-page form)	MCL 600.5714(1)(a), MCL 600.5716, MCL 600.5718, MCL 600.5775(2)(f)	(3/16) version can be used until stock is depleted
dc100b	6/19	Demand for Possession, Damage/Health Hazard to Property, Landlord-Tenant	MCL 600.5714(1)(d), MCL 600.5716, MCL 600.5718	(3/16) version can be used until stock is depleted
dc100bnoinstructions	6/19	Demand for Possession, Damage/Health Hazard to Property, Landlord-Tenant (two-page form)	MCL 600.5714(1)(d), MCL 600.5716, MCL 600.5718	(3/16) version can be used until stock is depleted
dc100c	6/19	Notice to Quit to Recover Possession of Property, Landlord-Tenant	MCL 600.5714(1)(c)(iii), (e)	(3/15) version can be used until stock is depleted
dc100cnoinstructions	6/19	Notice to Quit to Recover Possession of Property, Landlord-Tenant	MCL 600.5714(1)(c)(iii), (e)	(3/15) version can be used until stock is depleted
dc100d	6/19	Demand for Possession, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination)	MCL 600.5716, MCL 600.5718, MCL 600.5775, MCL 600.5777	(3/16) version can be used until stock is deleted
dc100dnoinstructions	6/19	Demand for Possession, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination) (two-page form)	MCL 600.5716, MCL 600.5718, MCL 600.5775, MCL 600.5777	(3/16) version can be used until stock is depleted
dc100e	6/19	Demand for Possession, Termination of Tenancy Due to Unlawful Drug Activity on Premises, Landlord-Tenant	MCL 600.5714(1)(b), MCL 600.5716, MCL 600.5718	(3/16) version can be used until stock is depleted
dc100enoinstructions	6/19	Demand for Possession, Termination of Tenancy Due to Unlawful Drug Activity on Premises, Landlord-Tenant (two-page form)	MCL 600.5714(1)(b), MCL 600.5716, MCL 600.5718	(3/16) version can be used until stock is depleted
dc101	3/12	Forfeiture Notice, Land Contract	MCL 600.5728, MCL 600.5730
dc102a	12/19	Complaint, Nonpayment of Rent, Landlord-Tenant	MCR 2.113(C), MCR 4.201(B), MCL 600.5714	Courts may accept the (6/17) version until stock is depleted if no demand for jury is being made.
dc102b	12/19	Complaint, Damage/Health Hazard to Property, Landlord-Tenant	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	Courts may accept the (6/17) version until stock is depleted if no demand for jury is being made.
dc102c	12/19	Complaint to Recover Possession of Property	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	Courts may accept the (6/17) version until stock is depleted if no demand for jury is being made.
dc102d	12/19	Complaint, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination)	MCL 600.5779, MCR 2.113(C), MCR 4.201(B)	Courts may accept the (6/17) version until stock is depleted if no demand for jury is being made.
dc103	3/11	Complaint for Possession after Land Contract Forfeiture	MCL 600.5726, MCL 600.5739, MCR 2.113(C), MCR 4.202(D)
dc104	6/17	Summons, Landlord-Tenant/Land Contract	MCL 600.5735, MCR 2.102, MCR 4.201(C), MCR 4.202(E)	(3/12) Can be used until 12/31/2017
dc105	6/17	Judgment, Landlord-Tenant	MCL 600.5744, MCR 4.201(K)(1)(d)	(3/15) version can be used until stock is depleted
dc105a	3/15	Judgment, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination)	MCL 125.2328(1)(h), MCL 125.2328a(4), MCL 600.5783, MCR 4.201(K), 50 USC 521	(1/12) version can be used until stock is depleted
dc106	3/16	Judgment of Possession after Land Contract Forfeiture	MCL 600.5741, MCL 600.5744(3), MCR 4.202(J), 50 USC App 521	(3/11) version can be used until 12/31/2016
dc107	3/16	Application and Order of Eviction, Landlord-Tenant/Land Contract	MCL 600.5744, MCR 4.201(L), MCR 4.202(K)	(3/15) version can be used until stock is depleted
dc109	6/19	Motion and Order for Escrow, Landlord-Tenant	MCR 4.201	(6/05) version can be used until stock is depleted
dc110	3/16	Order to Release Escrow, Landlord-Tenant/Land Contract	MCR 4.201(N)	(4/87) verison can be used until stock is depleted; previous version number was DCH 110
dc111a	6/19	Answer, Nonpayment of Rent, Landlord-Tenant	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	(1/12) version can be used until stock is depleted
dc111anoinstructions	6/19	Answer, Nonpayment of Rent, Landlord-Tenant	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	(1/12) version can be used until stock is depleted
dc111b	6/19	Answer, Damage/Health Hazard to Property, Landlord-Tenant	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	(3/15) version can be used until stock is depleted
dc111bnoinstructions	6/19	Answer, Damage/Health Hazard to Property, Landlord-Tenant	MCL 600.5714, MCR 2.113(C), MCR 4.201(B)	(3/15) version can be used until stock is depleted
dc111c	6/19	Answer to Complaint to Recover Possession of Property	MCL 600.5720, MCR 2.113(C), MCR 4.201(B)	(1/12) version can be used until stock is depleted
dc111cnoinstructions	6/19	Answer to Complaint to Recover Possession of Property	MCL 600.5720, MCR 2.113(C), MCR 4.201(B)	(1/12) version can be used until stock is depleted
dc111d	6/19	Answer, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination)	MCL 600.5720, MCR 2.113(C), MCR 4.201(B)	(3/15) version can be used until stock is depleted
dc111dnoinstructions	6/19	Answer, Termination of Tenancy, Mobile Home Park - Mobile Home Owner (Just-Cause Termination)	MCL 600.5720, MCR 2.113(C), MCR 4.201(B)	(3/15) version can be used until stock is depleted
dc118	6/18	Complaint and Summons Regarding Dangerous Animal	MCL 287.286a, MCL 287.322	(3/09) version can be used until depleted
dc119	9/17	Order Regarding Dangerous Animal	MCL 287.286a, MCL 287.322	Existing paper stock can be used until 12/31/2017
dc213	6/18	Advice of Rights and Plea Information (also available in Arabic, Chinese, Hmong, Korean, Russian, and Spanish)	MCL 750.504, MCL 770.3, MCR 1.110, MCR 6.610, 18 USC 922(g)(9)	(3/12) version can be used until 12/31/2018
dc214	11/83	Waiver of Privilege Against Disclosure (Alcohol/Substance Abuse Treatment)
dc215	6/04	Affidavit of Incorrect Address
dc223	7/11	Plea By Mail	MCR 6.610
dc225	12/19	Complaint, Misdemeanor	MCL 780.581, MCR 6.102(F)	(3/16) version can not be used after 12/31/19
dc226	3/16	Warrant, Misdemeanor, Traffic/Nontraffic	MCL 780.581, MCR 6.102(F), MCR 6.615	(5/07) version can be used until 12/31/2016
dc243	6/18	Order of Probation (Misdemeanor)	MCL 600.4803, MCL 769.1a, MCL 771.1 et seq., MCL 775.22, MCL 780.826, MCR 6.445, 18 USC 922(g)(8)	(9/15) version can be used until 12/31/2018
dc255	3/16	Notice to Prosecuting Official (Victim’s Rights Act)	MCL 780.811, MCL 780.816	(6/04) version can be used until 6/10/2016
dc504	4/20	Verification of Compliance with CARES Act	P.L. 116-136	NEW FORM

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