Free pc624.pmd - Michigan

Approved, SCAO

JIS CODE: RFN

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

FILE NO. REQUEST FOR NOTICE GUARDIANSHIP CONSERVATORSHIP

In the matter of

1. The person named above is a resident of or is present in this county. His/her current address is .
Address City State Zip

2. I request mailed notice pursuant to MCL 700.5104(1) be given to
Name (type or print) Address City, state, zip Telephone no.

me only

my attorney only

at:

3. I am an interested person in this matter as 4. My interest in this matter is:

State your relationship

Date Signature

Do not write below this line - For court use only

PC 624 (9/07)

REQUEST FOR NOTICE

MCL 700.5104(1), MCR 5.125, MCR 5.126