Free mc256.p65 - Michigan

Approved, SCAO

Original - Court 1st copy - Defendant

2nd copy - Prosecutor 3rd copy - Defendant attorney

STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT
ORI Court address

CASE NO. SUMMONS Criminal DISTRICT CIRCUIT
Court telephone no.

MI-

THE PEOPLE OF The State of Michigan
Co-defendant(s) City/Twp./Village Police agency report no. Witnesses

Defendant's name and address

Victim or complainant Complaining witness Date: On or about

v

County in Michigan Charge

Defendant CTN

Defendant SID Maximum penalty Defendant DLN

Defendant DOB

STATE OF MICHIGAN, COUNTY OF . The complaining witness has filed a sworn complaint in this court stating that on the date and the location described, the defendant, contrary to law,

IN THE NAME OF THE PEOPLE OF

THE STATE OF MICHIGAN

TAKE NOTICE: YOU ARE SUMMONED TO APPEAR for arraignment on
Day and date

at
Time

m., at

the address above
Location

, Michigan,

before the presiding judge. If you fail to appear, a warrant will be issued for your arrest upon the prosecutor's request. This summons expires on the date of hearing. If you require special accommodations to use the court because of disabilities, please contact the court immediately to make arrangements.
This document must be sealed by the seal of the court.

Requested on
Date Prosecuting official

by:

Date MC 256 (5/07)

Judge/Magistrate/Court clerk

Bar no. MCR 6.103(B)

SUMMONS, Criminal

SUMMONS, Criminal PROOF OF SERVICE Case No.

CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE OR OFFICER CERTIFICATE I certify that I am a sheriff, deputy sheriff, bailiff, appointed court officer, or attorney for a party [MCR 2.104(A)(2)], and that: (notary not required) AFFIDAVIT OF PROCESS SERVER Being first duly sworn, I state that I am a legally competent adult who is not a party or an officer of a corporate party, and that: (notary required)

I served personally a copy of the summons, I served by registered or certified mail (copy of return receipt attached) a copy of the summons, together with
Attachment Defendant's name Complete address(es) of service Day, date, time

, on:

I have personally attempted to serve the summons, together with
Attachment

on
Name

at
Address

and have been unable to complete service.

I declare that the statements above are true to the best of my information, knowledge, and belief.
Service fee Miles traveled Mileage fee Total fee Signature Name (type or print) Title

$

$

$

Subscribed and sworn to before me on
Date

, Signature:

County, Michigan.

My commission expires:
Date

Deputy court clerk/Notary public

ACKNOWLEDGMENT OF SERVICE I acknowledge that I have received service of the summons, together with
Attachment

on
Day, date, time

on behalf of
Signature

.

MCR 2.105