Free pc550.p65 - Michigan

Approved, SCAO

JIS CODE: OED

STATE OF MICHIGAN PROBATE COURT COUNTY OF In the matter of 1. Date of hearing: THE COURT FINDS:

ORDER ESTABLISHING DEATH OF ACCIDENT OR DISASTER VICTIM

FILE NO.

, presumed decedent Judge:
Bar no.

2. Notice of hearing was given to or waived by all interested persons. 3. An accident or disaster occurred on to have died:
Name Date

in which the following person was killed or may be presumed

XXX-XXLast four digits of social security no. Street address Date of birth City State Zip

4. The accident or disaster occurred at 5. The above described person is dead. 6. The date of death is 7. The time of death is at or about
Time Date

.

.

m.

is not possible to ascertain. IT IS ORDERED the death of the presumed decedent is established in accordance with the above findings.

Date

Judge

Do not write below this line - For court use only

PC 550 (9/05)

ORDER ESTABLISHING DEATH OF ACCIDENT OR DISASTER VICTIM

MCL 700.1207, MCL 700.1208