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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.

 

  
  
  
Citation
Previous Versions
Advice of Rights after Order Terminating Parental Rights (Juvenile Code)
  
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)
  
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
  
1/21
Absent Parent Protocol
(12/17) version - existing stock may be used through December 31, 2021
Affidavit of Service Performed by Lawyer-Guardian Ad Litem
  
1/21
MCL 712A.17d, MCR 3.915
(9/11) version - existing stock may be used through December 31, 2021
Appearance of Attorney/Guardian Ad Litem/Lawyer-Guardian Ad Litem
  
1/21
MCR 3.915(C), MCR 3.916
(6/03) version - existing stock may be used through December 31, 2021
Application to Set Aside Adjudication(s)
  
4/21
MCL 28.241a(b), MCL 712A.18e, MCR 3.925(F)
(12/19) version can be used until July 3, 2021
Authorization for Return of Bond
  
9/20
MCR 3.604, MCR 3.935(F)(4)
(9/06) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Blank (does not contain SCAO approval) (for second sheets or general purpose)
  
6/03
Claim of Appeal and Order Appointing Appellate Counsel
  
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)
  
5/21
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
(12/18) version - existing stock may be used through December 31, 2021
Confidential Case Inventory (Domestic Relations and Juvenile Code)
  
9/19
MCR 3.206, MCR 3.931, MCR 3.961
(8/18) version can be used until September 18, 2019
Diversion Record
  
6/03
MCL 722.821 et seq., MCR 3.932(A)
Ex Parte Renewal of Restoration Order (Delinquency Proceedings)
  
1/21
MCL 712A.18s(3)
(10/13) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Financial Statement
  
6/03
Findings Following Putative Father Hearing
  
1/21
MCR 3.921(D)
(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Judgment of Sentence/Commitment to Department of Corrections (Designated Case)
  
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)
  
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
  
1/21
MCL 712A.18(19)
(11/05) version - existing stock may be used through December 31, 2021
Motion and Order for Modification or Cancellation of Restitution Owed
  
1/21
MCL 780.794
(11/05) version - existing stock may be used through December 31, 2021
Motion and Order to Close Proceedings to Public
  
1/21
MCL 712A.17(7), MCR 3.925(A)
(11/05) version - existing stock may be used through December 31, 2021
Motion for Alternate Service
  
1/21
MCL 712A.13, MCR 3.920(B)(4)(b)
(9/16) version - existing stock may be used through December 31, 2021
Motion Re Transfer/Hearing/Placement and Authorization/Denial/Notice of Hearing
  
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
  
1/21
MCL 712A.4, MCR 3.950
(6/03) version - existing stock may be used through December 31, 2021
Notice of Diversion Conference
  
10/20
MCL 722.824, MCL 722.825, MCR 3.932(A)
(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Notice of Hearing
  
10/20
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)
(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Notice of Hearing on Probation Violation
  
10/20
MCR 3.920(C), MCR 3.944(C)
(6/03) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to court rules.
Notice of Intent to Intercept State Income Tax
  
9/20
MCL 712A.18(2), MCL 769.1(7)
(6/03) - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Notice of Proceedings Concerning An Indian Child
  
6/21
25 USC 1912, MCR 3.920(C)(1)
(5/21) - existing stock may be used through June 30, 2021
Notice to Putative Father
  
5/21
MCR 3.921(D)
(12/17) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order After Dispositional Review/Permanency Planning Hearing (Child Protective Proceedings)
  
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)
  
1/21
MCR 3.950(D)(1)
(12/19) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order After Hearing on Competency (Delinquency Proceedings)
  
1/21
MCL 712A.18q, MCL 712A.18r(5), MCL 712A.18s(1)
(10/13) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order After Posttermination Review/Permanency Planning Hearing (Child Protective Proceedings)
  
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)
  
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)
  
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)
  
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)
  
10/20
MCL 712A.13a, MCR 3.002, MCR 3.920(C)(2)(a), MCR 3.965(C), MCR 3.974, MCR 3.979(F)(2)
(12/18) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order after Second-Phase Hearing to Waive Jurisdiction (Delinquency Proceedings)
  
1/21
MCR 3.950(D)(2)
(11/05) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order Appointing Attorney/Guardian Ad Litem/Lawyer-Guardian Ad Litem
  
10/20
MCL 712A.17c(9), MCL 712A.17d,
MCR 3.915, MCR 3.916
(9/03) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order Cancelling Wage Assignment
  
6/03
MCL 712A.18b
Order Correcting Identifying Information (Child Protective Proceedings)
  
5/21
(9/16) version - existing stock can be used through December 31, 2021
Order Delaying Sentence (Designated Case)
  
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
  
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)
  
10/20
MCL 400.201 et seq., MCL 712A.18, MCL 712A.19a, MCL 712A.19b, MCL 712A.20, 25 USC 1912, MCR 3.977
(9/15) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order Following Report on Restoration (Delinquency Proceedings)
  
1/21
MCL 712A.18s(4)
(10/13) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order for Alternate Service
  
10/20
MCL 712A.13, MCR 3.920(B)(4)(b), (5)
(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order for Assignment of Wages
  
9/20
MCL 712A.18b
(12/19) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order for Competency Evaluation (Delinquency Proceedings)
  
1/21
MCL 712A.18n, MCL 712A.18o, MCL 712A.18p
(10/13) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order for Contempt of Court
  
10/20
MCL 600.1701, MCL 600.1715, MCL 600.1721, MCL 712A.6a, MCL 712A.26, MCR 3.928, MCR 3.987(F)
(9/09) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order for Reimbursement
  
10/20
MCL 712A.17c(8), MCL 712A.18, MCR 3.915(E), MCR 3.916(D)
(9/12) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order of Adjudication (Child Protective Proceedings)
  
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)
  
12/19
MCL 712A.18, MCR 3.942
(12/18)  version can be used until stock is depleted
Order of Disposition (Child Protective Proceedings)
  
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)
  
10/20
MCL 712A.18, MCL 712A.18f, MCL 712A.20, MCR 3.973(F)


(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order of Disposition, In-Home (Delinquency Proceedings)
  
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)
  
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)
  
1/21
MCL 712A.18, MCL 712A.18(1)(m), MCR 3.955, 18 USC 922(g)(8)(c)
(12/18) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order on Application to Set Aside Adjudication(s)
  
4/21
MCL 712A.18e, MCR 3.925(F)
(12/19) version can be used until July 3, 2021
Order Regarding Qualified Residential Treatment Program Placement
  
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)
  
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)
  
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
  
9/20
MCL 712A.18(2), MCL 769.1(7)
(6/03) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order to Intercept State Income Tax
  
9/20
MCL 712A.18(2), MCL 769.1(7)
(6/03) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order to Take Child(ren) into Protective Custody and Place (Child Protective Proceedings)
  
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 Terminate Court Jurisdiction
  
1/21
MCL 712A.18(2), MCL 712A.18o(4), MCL 712A.19(1)
*NEW FORM* (9/6) version of JC 36 - existing stock may be used through June 30, 2021
Order to Transfer Case
  
10/20
MCL 712A.2, MCR 3.926
(9/11) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Order Transferring Petition to Consent Calendar (Delinquency Proceedings)
  
10/20
MCL 712A.2f
(9/16) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Petition (Child Protective Proceedings)
  
1/21
MCL 712A.2, MCR 3.903(A)(19), MCR 3.926(A), MCR 3.961
(9/19) version - existing stock can be used through December 31, 2021
Petition (Delinquency Proceedings)
  
1/21
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
(9/19) version - existing stock may be used through December 31, 2021
Petition to Transfer Case to Tribal Court and Order
  
1/21
MCR 3.905(C)(1)
(12/18) version - existing stock may be used through December 31, 2021
Proof of Service/Nonservice
  
1/21
MCR 2.107(D), MCR 3.920(H)
(9/06) version - existing stock may be used through December 31, 2021
Proof of Service/Nonservice
  
10/20
MCR 2.107(D), MCR 3.920(I)
(9/06) version - existing stock may be used through December 31, 2021
Publication of Hearing
  
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
  
6/03
MCR 3.921(C)
Publication of Parental-Rights Termination Hearing
  
9/16
MCR 3.920(B)(4)(b), (5)(c)
New Form
Request and Order for Biometric Data Collection/Photographing/Lineup
  
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
  
1/21
MCR 3.915
(9/09) version - existing stock may be used through December 31, 2021
Request and Order for Review of Referee Recommendation
  
1/21
MCR 3.991
(6/03) version - existing stock may be used through December 31, 2021
Request for Court Appointed Appellate Counsel
  
3/21
MCR 3.993
(11/05) version existing stock cannot be used
Request for Financial Information
  
9/07
Request for Next Friend and Order
  
12/19
MCR 2.201(E), MCR 3.703(F)
*NEW FORM*
Request to Terminate Court Jurisdiction
  
1/21
MCL 712A.18(2), MCL 712A.18c(4), MCL 712A.19(1)
NEW FORM - (9/6) version of JC 36 - existing stock may be used through June 30, 2021
Summons:  Order to Appear (Child Protective Proceedings)
  
10/20
MCL 712A.13, MCR 3.911, MCR 3.912, MCR 3.915, MCR 3.920, MCR 3.928

(9/09) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Summons:  Order to Appear (DelinquencyProceedings)/(Personal Protection Proceedings)
  
10/20
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)
(9/09) version - existing stock may be used through September 30, 2021, as long as PII is protected or redacted according to the court rules.
Supplemental Order of Disposition (Delinquency Proceedings)
  
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)
  
9/07
Waiver and Consent to Enter Teen Court (Plea under Advisement)
  
9/07
Waiver of Attorney or Request for Appointment of Attorney
  
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
  
10/20
MCR 3.911, MCR 3.915, MCR 3.920(F)
(9/14) previous - existing stock may be used through December 31, 2021