Free jc99.pmd - Michigan

Approved, SCAO

JIS CODE: PRJ

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address

PETITION TO REVOKE JUVENILE GUARDIANSHIP, NOTICE OF HEARING, AND ORDER FOR INVESTIGATION

CASE NO.

Court telephone no.

1. In the matter of
name, alias(es), DOB

2. I am

a DHS representative.

the lawyer-guardian ad litem.

3. The reasons why the court should take action are:

4. I request that the court revoke the juvenile guardianship, reinstate jurisdiction over the child under the previous child protective proceeding, and place the child under the care and supervision of the Department of Human Services.
Date Address City, state, and zip Telephone no.

Signature of petitioner Name (type or print)

NOTICE OF HEARING A hearing on the above petition shall be held on
Day, date, and time Location

at before
Judge/Referee

.

TO ALL INTERESTED PERSONS (listed in MCR 3.921[C]): You are entitled to participate in this hearing. Any information you want the court to consider at this hearing must be submitted in writing and in advance to the court, the agency, the lawyer-guardian ad litem for the child, and, if any, the attorneys for the parties. ORDER FOR INVESTIGATION IT IS ORDERED: The Department of Human Services shall perform an investigation of the juvenile guardianship and file a written report of the investigation with the court no later than 7 days before the hearing on the above petition. The report shall include the reasons why the juvenile guardianship should be revoked and a recommendation regarding temporary placement, if necessary.

Recommended by:

Referee signature

Date

Judge

Bar no.

Do not write below this line - For court use only

MCR 3.979(F) JC 99 (6/09)

PETITION TO REVOKE JUVENILE GUARDIANSHIP, NOTICE OF HEARING, AND ORDER FOR INVESTIGATION