Free mc271.pmd - Michigan

Approved, SCAO

Distribution: Original - Governor 1st copy - Court 2nd copy - Prosecutor

3rd copy - Sheriff/DOC 4th copy - Defendant (Fugitive) 5th copy - Agent of demanding state

STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT
Court address

CASE NO. WAIVER OF EXTRADITION
Court telephone no.

The State of Michigan THE PEOPLE OF v

Defendant (Fugitive) name, address, and telephone no.

DLN

DOB

WAIVER I,
Name

, am the person wanted by on a pending arrest warrant charging the crime of
State

County,

. I waive the issuance and service of a Michigan Governor's Warrant and all other procedures incidental to extradition proceedings, including the right to an attorney unless I have already retained one. I voluntarily return to the demanding state in the custody of the agent of that state.
Date Signature

CERTIFICATION BY JUDGE The defendant named above personally appeared before me on this date and was advised of his/her legal rights as provided by law. The defendant freely and voluntarily executed this waiver of extradition in my presence. The sheriff of Michigan Department of Corrections
State

County, Michigan shall hold the defendant in custody without bail and .

shall deliver the defendant to the agents of

Date This waiver must be sealed with the seal of the court.

Judge

Bar no.

Send Governor's copy to: Governor's Office Attention: Extradition Officer Legal Division Olds Plaza 111 S. Capitol Lansing, Michigan 48933
MC 271 (3/09)

WAIVER OF EXTRADITION

MCL 780.25