Free mc290.pmd - Michigan

Approved, SCAO

Original - Court 1st copy - MDOC Regional Business Office 2nd copy - Prisoner

STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT
Court address

CASE NO. SATISFACTION OF FINANCIAL OBLIGATION

Court telephone no.

Defendant's name

THE PEOPLE OF

The State of Michigan

v
Prisoner no. DOB

SID Institution name and address

On
Date

this court entered an order to remit prisoner funds for payment toward

an obligation ordered in a judgment of sentence or other order. That financial obligation has been paid in full to the court as of
Date

.

Date

Court clerk/Deputy court clerk

CERTIFICATE OF MAILING I certify that on this date I served a copy of this satisfaction of financial obligation on the defendant and the institution/facility by firstclass mail addressed to their last-known addresses as defined in MCR 2.107(C)(3).

Date

Signature

MC 290 (9/08)

SATISFACTION OF FINANCIAL OBLIGATION