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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)
  
11/05
MCL 712A.21, MCL 710.27a, MCR 3.977(I), MCR 3.992, MCR 7.204(A)(1)(c)

Affidavit of Efforts to Locate Absent Parent
  
8/05
Children’s Foster Care Manual 722-6, Absent Parent Protocol
Affidavit of Service Performed by Lawyer-Guardian Ad Litem
  
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
  
6/03
MCR 3.915(C), MCR 3.916
Application to Set Aside Adjudication(s)
  
10/15
MCL 712A.18e, MCR 3.925(F)
(3/14) previous approved form which cannot be used after 12/31/2015
Authorization for Return of Bond
  
9/06
MCR 3.604, MCR 3.935(F)(4)
Blank (does not contain SCAO approval) (for second sheets or general purpose)
  
6/03
Bond for Appearance
  
11/05
MCR 3.604, MCR 3.935(C),(E),(F)
Claim of Appeal and Order Appointing Appellate Counsel
  
9/14
MCR 3.977(J)(2), MCR 3.993(A)(2), MCR 7.204, MCR 7.210(B)(3)
(9/12) previous approved form which can be used until December 31, 2014
Complaint (Request for Action, Child Protective Proceedings)
  
9/13
MCL 712A.2, MCL 712A.11, MCR 3.903(A)(9), MCR 3.963(A)

(3/10) previous approved form which can be used until stock is depleted
Complaint (Request for Action, Delinquency Proceedings)
  
3/10
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
(9/06) previous approved form which can be used until stock is depleted
Diversion Record
  
6/03
MCL 722.821 et seq., MCR 3.932(A)
Ex Parte Renewal of Restoration Order (Delinquency Proceedings)
  
10/13
MCL 712A.18s(3)
New Form
Financial Statement
  
6/03
Findings Following Putative Father Hearing
  
9/11
MCR 3.921(D)
Judgment of Sentence, Commitment to Jail (Designated Case)
  
6/15
MCL 12.206, MCL 712A.18g, MCL 712A.18i, MCL 712A.18j, MCL 712A.18k, MCR 3.936, MCR 3.955
(11/05) previous approved form which can be used until 12/31/15 with hand correction only.
Judgment of Sentence/Commitment to Department of Corrections (Designated Case)
  
6/15
MCL 12.206, MCL 712A.18(1)(m), MCL 712A.18g, MCL 712A.18k, MCR 3.936, MCR 3.955
(11/05) previous approved form which can be used until 12/31/15 with hand correction only.
Motion and Authorization/Denial
  
9/15
MCL 712A.13a(14), MCL 712A.17, MCL 712A.18d, MCL 712A.19(10), MCL 712A.21, MCL 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)

(6/03) previous approved form which can be used until stock is depleted
Motion and Order for Modification
  
11/05
MCL 712A.18
Motion and Order for Modification or Cancellation
  
11/05
MCL 712A.18(19)
Motion and Order to Close Proceedings to Public
  
11/05
MCL 712A.17(7), MCR 3.925(A)
Motion for Alternate Service
  
6/03
MCR 3.920(B)(4)
Motion to Waive Jurisdiction and Notice
  
6/03
MCL 712A.4, MCR 3.950
Notice of Diversion Conference
  
6/03
MCL 722.824, MCL 722.825, MCR 3.932(A)
Notice of Hearing
  
9/07
MCL 712A.19(5), MCL 712A.19a,
MCL 712A.19b, 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)
Notice of Hearing on Probation Violation
  
6/03
MCR 3.920(C), MCR 3.944(C)
Notice of Intent to Intercept State Income Tax
  
6/03
MCL 712A.18(2), MCL 769.1(7)
Notice of Proceedings Concerning An Indian Child
  
7/11
25 USC 1912, MCR 3.920(C)(1)
Notice to Putative Father
  
11/05
MCR 3.921(C)
Order after First-Phase Hearing to Waive Jurisdiction (Delinquency Proceedings)
  
11/05
Order After Hearing on Competency (Delinquency Proceedings)
  
10/13
MCL 712A.18q, MCL 712A.18r(5), MCL 712A.18s(1)
New Form
Order after Post-Termination Review/Permanency Planning Hearing
  
9/15
MCL 712A.19, MCL 712A.19c, MCL 712A.20, MCR 3.978, MCR 3.979

(9/14) previous version of forms which can be used until 6/30/2016
Order after Preliminary Hearing (Child Protective Proceedings)
  
9/15
MCL 712A.2(b), MCL 712A.13a, MCL 712A.14, MCL 712A.19a(2), MCL 712A.19b(4), MCL 722.638, MCR 3.920(C), MCR 3.921(C), MCR 3.965


(9/13) previous approved form which can be used until 6/30/2016
Order after Preliminary Hearing/Inquiry (Delinquency/Personal Protection)
  
10/13
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
(09/10), (3/10) previous approved forms which can be used until stock is depleted
Order after Pretrial Hearing (Child Protective Proceedings)
  
9/15
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

(9/13) previous approved form which can be used until 6/30/2016
Order after Second-Phase Hearing to Waive Jurisdiction (Delinquency Proceedings)
  
11/05
Order Appointing Attorney/Guardian Ad Litem/Lawyer-Guardian Ad Litem
  
9/03
MCL 712A.17c(9), MCL 712A.17d(2),
MCR 3.915, MCR 3.916
Order Appointing Next Friend (Personal Protection Proceedings)
  
11/05
Order Cancelling Wage Assignment
  
6/03
MCL 712A.18b
Order Correcting Identifying Information (Child Protective Proceedings)
  
9/08
 MCR 2.612(A)
Order Delaying Sentence (Designated Case)
  
6/15
MCL 12.206, MCL 712A.18(1)(m), MCL 712A.18k, MCR 3.936, MCR 3.955(D)
(1/11) previous approved form which can be used until 12/31/15 with hand correction only.
Order Denying Appointment of Appellate Counsel
  
9/07
MCR 3.977(l), MCR 3.993(A)(2), MCR 7.205
Order Following Dispositional Review/Permanency Planning Hearing (Child Protective Proceedings)
  
9/15
MCL 712A.17d(1)(c), MCL 712A.18f, MCL 712A.19, MCL 712A.19a, MCL 712A.20, MCR 3.002, MCR 3.921(C), MCR 3.974(A)(3), MCR 3.975, MCR 3.976(B)(1), MCR 3.979
(9/14) previous approved forms which can be used until 6/30/2016
Order Following Hearing to Terminate Parental Rights (Child Protective Proceedings)
  
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 Removal Hearing (Child Protective Proceedings)
  
9/15
MCL 712A.13a, MCR 3.002, MCR 3.920(C)(2)(a), MCR 3.965(C), MCR 3.974, MCR 3.979(F)(2)
(9/13) previous approved form which can be used until 12/31/2015
Order Following Report on Restoration (Delinquency Proceedings)
  
10/13
MCL 712A.18s(4)
New Form
Order for Alternate Service
  
9/15
MCR 3.920(B)(4),(5)
(9/07) previous approved form which can be used until stock is depleted
Order for Assignment of Wages
  
6/03
MCL 712A.18b
Order for Competency Evaluation (Delinquency Proceedings)
  
10/13
MCL 712A.18n, MCL 712A.18o, MCL 712A.18p
New Form
Order for Contempt of Court
  
9/09
MCL 600.1701, MCR 600.1715, MCL 600.1721, MCL 712A.6a, MCL 712A.26, MCR 3.928, MCR 3.987(F)
Order for Reimbursement
  
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)
  
9/15
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 3.206(A)(4), MCR 3.921(C), MCR 3.972
(11/13) previous approved form which can be used until 6/30/2016
Order of Adjudication (Delinquency Proceedings)
  
9/09
MCL 712A.18, MCR 3.942
Order of Disposition (Child Protective Proceedings)
  
9/15
PL 96-272, 42 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 3.973(F)


(9/14) previous approved form which can be used until 6/30/2016
Order of Disposition, Child In-Home (Child Protective Proceedings)
  
9/15
MCL 712A.18, MCL 712A.18f, MCL 712A.20, MCR 3.973(F)


(9/06) previous approved form which can be used until 6/30/2016
Order of Disposition, Commitment or Referral to Department of Human Services (Delinquency Proceedings)
  
6/15
MCL 400.55(h), MCL 712A.18, MCL 712A.18k, MCL 712A.20, MCL 712A.24, MCL 803.301, MCR 3.936, MCR 3.943


(12/10) previous approved form which can be used until 12/31/15 with hand correction only.
Order of Disposition, In-Home (Delinquency Proceedings)
  
6/15
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


(12/10) previous approved form which can be used until 12/31/15 with hand correction only.
Order of Disposition, Out-of-Home (Delinquency Proceedings)
  
6/15
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


(12/10) previous approved form which can be used until 12/31/15 with hand correction only.
Order of Probation (Designated Case)
  
6/15
MCL 712A.18, MCL 712A.18(1)(m), MCR 3.955, 18 USC 922(g)(8)(c)
(12/10) previous approved form which can be used until 12/31/15 with hand correction only.
Order on Application to Set Aside Adjudication(s)
  
10/15
MCL 712A.18e, MCR 3.925(F)
(1/13) previous approved form which cannot be used after 12/31/2015
Order Removing Alleged Abuser from Child's Home (Child Protective Proceedings)
  
9/15
MCL 712A.13a
(9/07) previous approved form which can be used until stock is depleted
Order to Apprehend and Detain (Delinquency Proceedings/Minor Personal Protection)
  
9/10
MCL 712A.2c, 712A.15, MCR 3.933(B),(C),
MCR 3.934(B), MCR 3.944(A), MCR 3.983(B),(D)
(9/08) previous approved form which can be used until stock is depleted
Order to Cancel State Income Tax Intercept
  
6/03
MCL 712A.18(2), MCL 769.1(7)
Order to Intercept State Income Tax
  
6/03
MCL 712A.18(2), MCL 769.1(7)
Order to Take Child(ren) into Protective Custody and Place (Child Protective Proceedings)
  
9/15
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) 

(9/14) previous approved form which can be used until 6/30/2016
Order to Transfer Case
  
9/11
MCL 712A.2, MCR 3.926
(9/10) previous approved form which can be used until stock is depleted
Order Transferring Petition from Formal Calendar to Consent Calendar
  
9/06
 MCR 3.932(C)
Petition (Child Protective Proceedings)
  
9/13
MCL 712A.2, MCR 3.903(A)(19), MCR 3.926(A), MCR 3.961
(9/12), (9/11), (9/10) previous approved forms which can be used until stock is depleted
Petition (Delinquency Proceedings)
  
6/15
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
(3/10) previous approved form which can be used until 12/31/15 with hand correction only.
Proof of Service/Nonservice
  
9/06
MCR 2.107(D), MCR 3.920(H)
Proof of Service/Nonservice
  
9/06
MCR 2.107(D), MCR 3.920(H)
Publication of Hearing
  
9/07
MCR 3.920(B)(4)(b), (5)(c)
Publication of Hearing, Notice to Putative Father
  
6/03
MCR 3.921(C)
Record of Trial/Plea
  
6/03
MCL 712A.18(1), MCR 3.925(B), MCR 3.941, MCR 3.942, MCR 3.971, MCR 3.972
Request and Order for Court-Appointed Appellate Counsel
  
11/05
MCR 3.915(B)
Request and Order for Court-Appointed Attorney
  
9/09
MCR 3.915
Request and Order for Fingerprinting/Photographing/Lineup
  
6/03
MCL 712A.32, MCR 3.923(C)
Request and Order for Review of Referee Recommendation
  
6/03
MCR 3.991
Request for Financial Information
  
9/07
Request to Terminate Court Jurisdiction and Order
  
9/06
MCL 712A.18(2), MCL 712A.18c(4),
MCL 712A.19(1), MCR 3.932(C)(7)
Summons:  Order to Appear (Child Protective Proceedings)
  
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)
  
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 Following Review Hearing (Delinquency Proceedings)
  
9/10
MCL 712A.18, MCL 712A.18c, MCL 712A.18d, MCL 712A.19, MCL 712A.20, MCL 712A.24, MCR 3.945
(9/07) previous approved form which can be used until stock is depleted except for cases involving IV-E funded youth

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
  
11/05
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)

Waiver of Summons/Notice of Hearing
  
9/14
MCR 3.911, MCR 3.915, MCR 3.920(E)
(11/05) previous approved form can be used until December 31, 2014