Free cc298.pmd - Michigan

Approved, SCAO

Original - Circuit court 1st copy - District/Municipal court

2nd copy - Appellee 3rd copy - Appellant

STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
Court address

APPLICATION FOR LEAVE TO APPEAL AND NOTICE OF HEARING

CASE NO. DISTRICT MUNICIPAL
Court telephone no.

Plaintiff's name, address, and telephone no.

Appellant Appellee v

Defendant's name, address, and telephone no.

Appellant Appellee

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

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

1.

Name Date

, requests leave to appeal an order or a judgment entered on in the
Court name and number or county Bar no.

Court of the State of Michigan, .

by Hon. 2. a. b. a. b.

No appeal of right exists. The time for taking an appeal under MCR 7.101(B)(1) has expired. 3. This application for leave is being filed within 21 days of the order or judgment date and, therefore, is timely. This application for leave is being filed more than 21 days after the order or judgment date, but not more than 6 months thereafter. (The affidavit explaining delay on the other side of this form has been completed.) 4. The grounds for appeal are: (Attach additional pages as needed.)

5. The proceedings in the district/municipal court were: (Describe the proceedings.)

Date

Appellant/Attorney signature

NOTICE OF HEARING A hearing is scheduled on the appellant's request for leave to appeal on at
Location Date

at

Time Bar no.

before Hon.

.

CERTIFICATE OF MAILING I certify that on this date I served a copy of this application for leave to appeal and notice of hearing on the appellee or his/her attorney by first-class mail addressed to his/her last-known address as defined in MCR 2.107(C)(3).
Date Appellant signature

CC 298 (3/08)

APPLICATION FOR LEAVE TO APPEAL AND NOTICE OF HEARING

MCR 7.103

AFFIDAVIT EXPLAINING DELAY This application is being filed more than 21 days but not more than 6 months after the entry of the order or judgment being appealed because: (Explain in detail the reasons for the delay in filing.)

Appellant/Attorney signature

Subscribed and sworn to before me on
Date

, Signature:

County, Michigan.

My commission expires:

Date

Notary public, State of Michigan, County of