Free mc264.p65 - Michigan

Approved, SCAO

STATE OF MICHIGAN
JUDICIAL DISTRICT JUDICIAL CIRCUIT COUNTY PROBATE Court address

CASE NO. ORDER OF DISQUALIFICATION / REASSIGNMENT
Court telephone no.

Plaintiff name(s) and address(es)

Defendant name(s) and address(es)

v

Plaintiff's attorney, bar no., address, and telephone no.

Defendant's attorney, bar no., address, and telephone no.

In the matter of IT IS ORDERED: Judge , is requesting assignment of another judge a. b. c. d. e. for the following reason:
Bar no.

on motion of

disqualified under MCR 2.003 from hearing this case

Interested as a party. Personally biased or prejudiced for or against a party or attorney. Consulted or employed as an attorney in the matter in controversy. Was a partner of a party, attorney for a party, or a member of a law firm representing a party within the preceding two years. Related within the third degree (civil law) of consanguinity or affinity to a person acting as an attorney or within the sixth degree (civil law) to a party. f. The judge's spouse or minor child owns a stock, bond, security, or other legal or equitable interest in a corporation which is a party, unless specifically excepted by MCR 2.003(B)(6)(a)(b) or (c). g. Other: (specify)

Date

Judge

Bar no.

INTERNAL REASSIGNMENT REQUEST Judge
Bar no.

has been chosen by lot or local administrative

order from the judges not disqualified in this case. I request that this case be reassigned to this judge.
Date Court Administrator or Clerk of the Court

Reassignment approved as requested.
Date Chief Judge Bar no.

IF ALL JUDGES OF THIS COURT ARE DISQUALIFIED - SEE REVERSE SIDE FOR REASSIGNMENT TO A JUDGE OF ANOTHER COURT
MC 264 (3/06)

ORDER OF DISQUALIFICATION/REASSIGNMENT

MCR 2.003, MCR 8.111(C)

ADDITIONAL DISQUALIFICATIONS
NOTE: If there are not enough signature slots, attach additional sheets

The undersigned judge(s) is/are also disqualified and refer by letter to the reason printed on the front of this form. NOTE: IF REASON (g) IS ENTERED THE COMMENT SECTION MUST BE COMPLETED.
REASON a-g DATE SIGNATURE COMMENT

Initial here if you have decided not to disqualify yourself.

CHIEF JUDGE DISQUALIFICATION AND REQUEST FOR REFERRAL TO SCAO All of the judges of this court have disqualified themselves and have signed this order, indicating their reason for disqualification pursuant to MCR 2.003. I am also disqualified for the following reason .

The designated Visiting Judge Clerk shall submit a copy of this order, ALONG WITH THE REQUEST FOR ASSIGNMENT, form SCAO 1, to the appropriate State Court Administrative Office to have another judge assigned to hear this case pursuant to MCR 2.003(C)(4).

Date

Chief Judge

Bar no.