Juvenile

Index of SCAO-Approved Forms for Use in

Delinquency, Child Protective, and Other Juvenile Proceedings

This set of forms is used in delinquency, child protective, and other juvenile proceedings, including juvenile guardianship and designated cases. The forms must be filed in the family division of circuit court. See also indexes for general and criminal forms which are used in juvenile proceedings as appropriate.

Title	Name	Date	Citation	Previous Versions
Advice of Rights after Order Terminating Parental Rights (Juvenile Code)	jc44	1/21	MCL 710.27a, MCL 712A.21, MCR 3.977(J), MCR 3.992, MCR 3.993, MCR 7.204(A)(1)(c), MCR 7.205(A)(3)	(4/18) Previous versions cannot be used
Advice of Rights Regarding Appeal (Child Protective Proceedings)	jc111	8/19	MCL 712A.21, MCR 3.965, MCR 3.967, MCR 3.971, MCR 3.972, MCR 3.973, MCR 3.974, MCR 3.992, MCR 3.993	New Form
Affidavit of Efforts to Locate Absent Parent	jc83	12/17	Absent Parent Protocol	(8/05) version approved form can be used until stock is depleted
Affidavit of Service Performed by Lawyer-Guardian Ad Litem	jc82	9/11	MCL 712A.17d, MCR 3.915	(9/07) previous approved form which can be used until stock is depleted
Appearance of Attorney/Guardian Ad Litem/Lawyer-Guardian Ad Litem	jc07	6/03	MCR 3.915(C), MCR 3.916
Application to Set Aside Adjudication(s)	jc66	12/19	MCL 28.241a(b), MCL 712A.18e, MCR 3.925(F)	(8/18) version can be used until stock is depleted
Authorization for Return of Bond	jc31	9/06	MCR 3.604, MCR 3.935(F)(4)
Blank (does not contain SCAO approval) (for second sheets or general purpose)	jc22	6/03
Claim of Appeal and Order Appointing Appellate Counsel	jc84	3/21	25 USC 1912, MCR 3.993, MCR 7.204, MCR 7.210(B)(3)	(12/18) version existing stock cannot be used
Complaint (Request for Action, Delinquency Proceedings)	jc01	12/18	MCL 712A.2, MCL 712A.11, MCL 712A.14, MCL 712A.15, MCR 3.903(A)(9), MCR 3.933(A), MCR 3.934, MCR 3.983	(12/17) version can be used until 6/30/2019
Confidential Case Inventory (Domestic Relations and Juvenile Code)	mc21	9/19	MCR 3.206, MCR 3.931, MCR 3.961	(8/18) version can be used until September 18, 2019
Diversion Record	jc55	6/03	MCL 722.821 et seq., MCR 3.932(A)
Ex Parte Renewal of Restoration Order (Delinquency Proceedings)	jc109	10/13	MCL 712A.18s(3)	New Form
Financial Statement	jc34	6/03
Findings Following Putative Father Hearing	jc106	9/16	MCR 3.921(D)	(9/11) version can be used until 6/30/2017
Judgment of Sentence/Commitment to Department of Corrections (Designated Case)	jc72	12/18	MCL 12.206, MCL 712A.18(1)(m), MCL 712A.18g, MCL 712A.18k, MCR 3.936, MCR 3.955	(6/15) version can be used until 6/30/2019
Judgment of Sentence/Commitment to Jail (Designated Case)	jc71	12/18	MCL 12.206, MCL 712A.18g, MCL 712A.18i, MCL 712A.18j, MCL 712A.18k, MCR 3.936, MCR 3.955	(9/16) version can be used until 6/30/2019
Motion and Order for Modification or Cancellation of Minimum State Costs Owed	jc52	11/05	MCL 712A.18(19)
Motion and Order for Modification or Cancellation of Restitution Owed	jc54	11/05	MCL 780.794
Motion and Order to Close Proceedings to Public	jc41	11/05	MCL 712A.17(7), MCR 3.925(A)
Motion for Alternate Service	jc46	9/16	MCL 712A.13, MCR 3.920(B)(4)(b)	(6/03) version can be used until stock is depleted
Motion Re Transfer/Hearing/Placement and Authorization/Denial/Notice of Hearing	jc15m_15a	4/21	MCL 712A.13a(14), MCL 712A.17, MCL 712A.18d, MCL 712A.19(10), MCL 712A.21, MCL 722.123a, 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)	(9/15) JC 15 version cannot be used
Motion to Waive Jurisdiction and Notice	jc18	6/03	MCL 712A.4, MCR 3.950
Notice of Diversion Conference	jc56	9/16	MCL 722.824, MCL 722.825, MCR 3.932(A)	(6/03) version can be used until stock is depleted
Notice of Hearing	jc45	9/16	MCL 712A.19(5), MCL 712A.19a, MCL 712A.19b, MCR 1.110, MCR 3.920(C), MCR 3.945(B)(1)(b), MCR 3.963(C)(2), MCR 3.975(B), MCR 3.976(C), MCR 3.977(C), MCR 3.978(B), MCR 3.985(C)	(9/07) version can be used until 6/30/2017
Notice of Hearing on Probation Violation	jc80	6/03	MCR 3.920(C), MCR 3.944(C)
Notice of Intent to Intercept State Income Tax	jc60	6/03	MCL 712A.18(2), MCL 769.1(7)
Notice of Proceedings Concerning An Indian Child	jc48	7/11	25 USC 1912, MCR 3.920(C)(1)
Notice to Putative Father	jc53	12/17	MCR 3.921(D)	(11/05) version approved form can be used until stock is depleted
Order After Dispositional Review/Permanency Planning Hearing (Child Protective Proceedings)	jc19	4/21	MCL 712A.17d(1)(c), MCL 712A.18f, MCL 712A.19, MCL 712A.19a, MCL 712A.20, MCL 722.123a, MCR 3.002, MCR 3.921(C), MCR 3.974(A)(3), MCR 3.975, MCR 3.976, MCR 3.979	(12/18) version cannot be used
Order After First-Phase Hearing to Waive Jurisdiction (Delinquency Proceedings)	jc86	12/19	MCR 3.950(D)(1)	(9/16) version can be used until 6/30/2020
Order After Hearing on Competency (Delinquency Proceedings)	jc108	10/13	MCL 712A.18q, MCL 712A.18r(5), MCL 712A.18s(1)	New Form
Order After Posttermination Review/Permanency Planning Hearing (Child Protective Proceedings)	jc76	4/21	MCL 712A.19, MCL 712A.19c, MCL 712A.20, MCL 722.123a, MCR 3.978, MCR 3.979	(12/18) version cannot be used
Order after Preliminary Hearing (Child Protective Proceedings)	jc11a	10/20	MCL 712A.2(b), MCL 712A.13a, MCL 712A.14, MCL 712A.19a(2), MCL 712A.19b(4), MCL 722.638, MCR 3.002, MCR 3.920(c), MCR 3.921(C), MCR 3.965	(12/18) version can be used until June 30, 2021
Order After Preliminary Hearing/Inquiry (Delinquency/Personal Protection)	jc10	1/21	25 USC 1912, PL - 96 - 272, 42 USC 670 et seq., MCL 712A.2, MCL 712A.11, MCL 712A.14, MCL 712A.15, MCR 3.905, MCR 3.920(C)(1), MCR 3.932, MCR 3.935	(12/19) version can be used until 6/30/2021
Order After Pretrial Hearing (Child Protective Proceedings)	jc11b	10/20	MCL 712A.2, MCL 712A.13a, MCL 712A.14, MCL 712A.19a(2), MCL 712A.19b(4), MCL 722.638, MCR 3.002, MCR 3.921(C), MCR 3.965	(12/18) version can be used until June 30, 2021
Order After Removal Hearing (Child Protective Proceedings)	jc75	12/18	MCL 712A.13a, MCR 3.002, MCR 3.920(C)(2)(a), MCR 3.965(C), MCR 3.974, MCR 3.979(F)(2)	(9/16) version can be used until 6/30/2019
Order after Second-Phase Hearing to Waive Jurisdiction (Delinquency Proceedings)	jc87	11/05	MCR 3.950(D)(2)
Order Appointing Attorney/Guardian Ad Litem/Lawyer-Guardian Ad Litem	jc03	9/03	MCL 712A.17c(9), MCL 712A.17d, MCR 3.915, MCR 3.916
Order Cancelling Wage Assignment	jc58	6/03	MCL 712A.18b
Order Correcting Identifying Information (Child Protective Proceedings)	jc90	9/16		(9/08) version can be used until stock is depleted.
Order Delaying Sentence (Designated Case)	jc73	12/18	MCL 12.206, MCL 712A.18(1)(m), MCL 712A.18k, MCR 3.936, MCR 3.955(D)	(12/17) version can be used until 6/30/2019
Order Denying Appointment of Appellate Counsel	jc85	3/21	MCR 3.977, MCR 3.993, MCR 7.204, MCR 7.205	(2/18) version existing stock cannot be used
Order Following Hearing to Terminate Parental Rights (Child Protective Proceedings)	jc63	9/15	25 USC 1912, MCL 400.201 et seq., MCL 712A.18, MCL 712A.19a, MCL 712A.19b, MCL 712A.20, MCR 3.977	(11/13) previous approved form which can be used until stock is depleted
Order Following Report on Restoration (Delinquency Proceedings)	jc110	10/13	MCL 712A.18s(4)	New Form
Order for Alternate Service	jc47	9/16	MCL 712A.13, MCR 3.920(B)(4)(b), (5)	(9/15) version can be used until stock is depleted
Order for Assignment of Wages	jc39	12/19	MCL 712A.18b	(6/03) version can be used until 6/30/2020
Order for Competency Evaluation (Delinquency Proceedings)	jc107	10/13	MCL 712A.18n, MCL 712A.18o, MCL 712A.18p	New Form
Order for Contempt of Court	jc40	9/09	MCL 600.1701, MCL 600.1715, MCL 600.1721, MCL 712A.6a, MCL 712A.26, MCR 3.928, MCR 3.987(F)
Order for Reimbursement	jc38	9/12	MCL 712A.17c(8), MCL 712A.18, MCR 3.915(E), MCR 3.916(D)	(6/03) previous approved form which can be used until stock is depleted
Order of Adjudication (Child Protective Proceedings)	jc49	4/21	MCL 712A.2, MCL 712A.13a, MCL 712A.14, MCL 712A.19a(2), MCL 712A.19b(4), MCL 722.638, MCR 3.002, MCR 3.205(A), MCR 3.921(C), MCR 3.972	(12/18) version existing stock cannot be used
Order of Adjudication (Delinquency Proceedings)	jc59	12/19	MCL 712A.18, MCR 3.942	(12/18) version can be used until stock is depleted
Order of Disposition (Child Protective Proceedings)	jc17	1/21	PL 96-272, 41 USC 670 et seq., MCL 400.55(h), MCL 400.203, MCL 712A.13a, MCL 712A.18, MCL 712A.18f, MCL 712A.19, MCL 712A.20, MCR 3.921(C), MCR 3.921(C), MCR 3.973	(12/18) version can be used until June 30, 2021
Order of Disposition, Child In Home (Child Protective Proceedings)	jc17a	9/16	MCL 712A.18, MCL 712A.18f, MCL 712A.20, MCR 3.973(F)	(9/15) version can be used until 6/30/2017
Order of Disposition, In-Home (Delinquency Proceedings)	jc14a	12/19	MCL 28.241a, MCL 600.2950h, MCL 600.2950m, MCL 712A.18, MCL 712A.18K, MCL 712A.20, MCL 764.15b, MCL 769.1f, MCL 769.16a, MCR 3.936, MCR 3.943	(12/18) version can be used until 6/30/2020
Order of Disposition, Out-of-Home (Delinquency Proceedings)	jc14b	12/19	MCL 28.241a, MCL 600.2950h, MCL 600.2950m, MCL 712A.18, MCL 712A.18K, MCL 712A.20, MCL 764.15b, MCL 769.1f, MCL 769.16a, MCR 3.936, MCR 3.943	(12/18) version can be used until 6/30/2020
Order of Probation (Designated Case)	jc74	12/18	MCL 712A.18, MCL 712A.18(1)(m), MCR 3.955, 18 USC 922(g)(8)(c)	(6/15) version can be used until 6/30/2019
Order on Application to Set Aside Adjudication(s)	jc105	12/19	MCL 712A.18e, MCR 3.925(F)	(12/18) version can be used until 6/30/2020
Order Regarding Qualified Residential Treatment Program Placement	jc15o	3/21	MCL 712A.13a(14), MCL 712A.17, MCL 712A.18d, MCL 712A.19(10), MCL 712A.21, MCL 722.123a(3), 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)	NEW FORM
Order Removing Alleged Abuser from Child's Home (Child Protective Proceedings)	jc65	9/16	MCL 712A.13a, MCL 764.15f	(9/15) version can be used until 6/30/2017
Order to Apprehend and Detain (Delinquency Proceedings/Minor Personal Protection)	jc05a	12/18	MCL 712A.2c, 712A.15, MCR 3.933(B),(C), MCR 3.934(B), MCR 3.944(A), MCR 3.983(B),(D)	(9/10) version can be used until stock is depleted
Order to Cancel State Income Tax Intercept	jc62	6/03	MCL 712A.18(2), MCL 769.1(7)
Order to Intercept State Income Tax	jc61	6/03	MCL 712A.18(2), MCL 769.1(7)
Order to Take Child(ren) into Protective Custody and Place (Child Protective Proceedings)	jc05b	12/18	MCL 712A.2(b), MCL 712A.14a, MCL 712A.19a(2), MCR 3.963(B), (C), (D)(2), MCR 3.974(C)(1), MCR 3.979(F)(2)	(9/16) version can be used until 6/30/2019
Order to Transfer Case	jc29	9/11	MCL 712A.2, MCR 3.926	(9/10) previous approved form which can be used until stock is depleted
Order Transferring Petition to Consent Calendar (Delinquency Proceedings)	jc89	9/16	MCL 712A.2f	Previous versions cannot be used
Petition (Child Protective Proceedings)	jc04b	9/19	MCL 712A.2, MCR 3.903(A)(19), MCR 3.926(A), MCR 3.961	(12/18) version can be used until September 18, 2019
Petition (Delinquency Proceedings)	jc04a	9/19	MCL 600.2950h-600.2950m, MCL 712A.2, MCL 712A.2d, MCL 764.15b, MCR 3.903(A)(19), MCR 3.926(A), MCR 3.931, MCR 3.944, MCR 3.951	(12/18) version can be used until September 18, 2019
Petition to Transfer Case to Tribal Court and Order	jc29a	12/18	MCR 3.905(C)(1)	New Form
Proof of Service/Nonservice	jc12a	9/06	MCR 2.107(D), MCR 3.920(H)
Proof of Service/Nonservice	jc12b	9/06	MCR 2.107(D), MCR 3.920(H)
Publication of Hearing	jc32	9/16	MCR 3.920(B)(4)(b), (5)(c)	(9/07) version can be used until stock is depleted if the requirements of MCR 3.920(B)(3)(b) are added
Publication of Hearing, Notice to Putative Father	jc79	6/03	MCR 3.921(C)
Publication of Parental-Rights Termination Hearing	jc32a	9/16	MCR 3.920(B)(4)(b), (5)(c)	New Form
Request and Order for Biometric Data Collection/Photographing/Lineup	jc16	12/19	MCL 28.241a(b), MCL 712A.32, MCR 3.923(C), (D)	(6/03) version can be used until stock is depleted
Request and Order for Court-Appointed Attorney	jc102	9/09	MCR 3.915
Request and Order for Review of Referee Recommendation	jc42	6/03	MCR 3.991
Request and Order to Terminate Court Jurisdiction	jc36	9/06	MCL 712A.18(2), MCL 712A.18c(4), MCL 712A.19(1)
Request for Court Appointed Appellate Counsel	jc81	3/21	MCR 3.993	(11/05) version existing stock cannot be used
Request for Financial Information	jc37	9/07
Request for Next Friend and Order	mc319	12/19	MCR 2.201(E), MCR 3.703(F)	NEW FORM
Summons: Order to Appear (Child Protective Proceedings)	jc21	9/09	MCL 712A.13, MCR 3.911, MCR 3.912, MCR 3.915, MCR 3.920, MCR 3.928
Summons: Order to Appear (DelinquencyProceedings) / (Personal Protection Proceedings)	jc20	9/09	MCL 712A.13, MCR 3.911, MCR 3.912, MCR 3.915, MCR 3.920, MCR 3.928, MCR 3.944, MCR 3.983(B)
Supplemental Order of Disposition (Delinquency Proceedings)	jc57	4/21	MCL 712A.15, MCL 712A.18, MCL 712A.18a, MCL 712A.18c, MCL 712A.18d, MCL 712A.19, MCL 712A.20, MCL 712A.24, MCL 722.123a, MCR 3.944, MCR 3.945	(12/18) version cannot be used
Waiver and Consent to Enter Teen Court (Diversion)	jc78	9/07
Waiver and Consent to Enter Teen Court (Plea under Advisement)	jc77	9/07
Waiver of Attorney or Request for Appointment of Attorney	jc06	1/21	MCR 3.915, MCR 3.935(B)(4), MCR 3.942(B)(3), MCR 3.944(B)(4),(C)(1)(b), MCR 3.946(C)(2), MCR 3.951(A)(2)(b)(i), MCR 3.985(B)(3), MCR 3.987(C)(3)	(11/05) Version cannot be used.
Waiver of Summons/Notice of Hearing	jc23	9/14	MCR 3.911, MCR 3.915, MCR 3.920(F)	(11/05) previous approved form can be used until December 31, 2014

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