Free mc283.pmd - Michigan

Approved, SCAO

Original - Court 1st copy - Law enforcement agency/Sheriff

2nd copy - Defendant/Juvenile 3rd copy - Prosecuting attorney 4th copy - Return

STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT
Court address

CASE NO. ORDER FOR DNA SAMPLE
Court telephone no.

The State of Michigan THE PEOPLE OF v

Defendant/Juvenile name, address, and telephone no.

CTN

SID

DOB

Juvenile In the matter of

1. On

Date

, the defendant/juvenile was convicted of or found responsible for violation(s) or , as prescribed in MCL 28.176, which

attempted violation(s) of require(s) that a DNA sample be taken. 2. The defendant/juvenile is IT IS ORDERED: 3. The defendant/juvenile shall provide a DNA sample to the on bond. incarcerated in

.

Name of investigating law enforcement agency/Sheriff

to be forwarded to the Department of State Police in accordance with MCL 712A.18k, MCL 28.171 to 28.176, MCL 750.520m, and State Police Rules by
Sentence date

.

4. The investigating law enforcement agency/sheriff named above shall file a return with the court that the sample was either taken or not required because a sample has already been taken.
Date Judge Bar no.

CERTIFICATION AND RETURN

I certify and return that a DNA sample of the defendant/juvenile was taken and forwarded to the Department of State Police as ordered above. was not taken because the Department of State Police already has a sample of the defendant/juvenile.
Date Law enforcement agent/Sheriff

See the other side for a list of persons subject to DNA profiling under MCL 750.520m.

MC 283 (3/09)

ORDER FOR DNA SAMPLE

MCL 712A.18k, MCL 750.520m

INSTRUCTIONS This form is to be used under MCL 750.520m to order the defendant/juvenile to provide samples of his or her blood for chemical testing for DNA identification profiling or a determination of the blood's genetic markers and shall provide samples of his or her saliva for chemical testing for a determination of the secretor status of the saliva when a defendant/juvenile is convicted of/found responsible for a violation or attempted violation as specified below.

PERSONS SUBJECT TO DNA IDENTIFICATION PROFILING UNDER MCL 750.520m If a defendant is charged with violations of and convicted of one of the following offenses, a DNA sample is required. OR If a juvenile is designated or jurisdiction of the juvenile is waived to circuit court for violations of and the juvenile is convicted (as an adult) of one of the following offenses, a DNA sample is required. MCL various MCL 750.145a MCL 750.167 MCL 750.335a MCL 750.451 MCL 750.454 MCL 750.462 Any felony or attempted felony Enticing a child for immoral purposes (includes ordinance violations) Disorderly person by window peeping, engaging in indecent or obscene conduct in public, or loitering in a house of prostitution (includes ordinance violations) Indecent exposure (includes ordinance violations) First and second prostitution (includes ordinance violations) Leasing a house for purposes of prostitution (includes ordinance violations) Female under age of 17 in a house of prostitution (includes ordinance violations)

If a juvenile is being processed as a juvenile in the family division of the circuit court and has been found responsible for one of the following offenses, a DNA sample is required. MCL 750.83 MCL 750.91 MCL 750.167 MCL 750.316 MCL 750.317 MCL 750.321 MCL 750.335a MCL 750.349 MCL 750.520b MCL 750.520c MCL 750.520d MCL 750.520e MCL 750.520g Assault with intent to commit murder or attempted Attempt to murder Disorderly person by window peeping, engaging in indecent or obscene conduct in public
(includes ordinance violations)

First-degree murder or attempted Second-degree murder or attempted Manslaughter or attempted Indecent exposure (includes ordinance violations) Kidnapping or attempted First-degree criminal sexual conduct or attempted Second-degree criminal sexual conduct or attempted Third-degree criminal sexual conduct or attempted Fourth-degree criminal sexual conduct or attempted Assault with intent to commit criminal sexual conduct or attempted