Free pc617.p65 - Michigan

Approved, SCAO

JIS CODE: DOI

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

FILE NO. DECLARATION OF INTENT TO GIVE NOTICE BY PUBLICATION

In the matter of Service of
Name City specify document(s) Address State Zip

cannot be made on

I intend to publish notice on this individual because his/her address or whereabouts are unknown. I have made the following diligent efforts to ascertain his/her address or whereabouts:

I declare under penalties of perjury that this declaration has been examined by me and that its contents are true to the best of my information, knowledge, and belief.

Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no.

Date Petitioner signature Address City, state, zip Telephone no.

NOTE: Complete a separate form (PC 617) for each person to be notified by publication. When publication is completed, prepare form PC 564 (Proof of Service), and cause an affidavit of publication to be filed with the court.

Do not write below this line - For court use only

PC 617 (9/05)

DECLARATION OF INTENT TO GIVE NOTICE BY PUBLICATION

MCR 5.105(A)(3)