Approved, SCAO Copies to: Trial court, Court Reporter(s)/ Recorder(s), Appointed Counsel, Defendant, Prosecutor, Court of Appeals, and MAACS STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court address CLAIM OF APPEAL AND ORDER APPOINTING COUNSEL Substitution of Counsel Order Amended CASE NO. AND SUFFIX Court telephone no. THE PEOPLE OF THE STATE OF MICHIGAN v Defendant's name (Last First Middle) OFFENSE NAME PACC CODE SENTENCE(S) Address, date of birth, and inmate no. (if known) Offense date for guilty plea 1. The defendant claims an appeal from a final judgment or order entered on Date in the Circuit Court, Bar no. County, Michigan by Judge . Copies of the final judgment or order being appealed and register of actions are attached for the Court of Appeals, appointed counsel, and Michigan Appellate Assigned Counsel System. 2. On Date the defendant filed a request for appointment of counsel and a declaration of indigency. IT IS ORDERED: 1. The State Appellate Defender Office, Suite 3300 Penobscot Building, 645 Griswold, Detroit, MI 48226 (313) 256-9833 OR Name of appellate counsel City, state, and zip Address Telephone no. Bar no. is appointed counsel for the defendant in postconviction proceedings. If appointed counsel cannot or will not accept this appointment, counsel shall notify the court immediately. 2. The court reporter(s)/recorder(s) shall file with the trial court clerk the transcripts checked below and any other transcripts requested by counsel in this case not previously transcribed. Transcripts shall be filed within 28 days for pleas or 91 days for trials from the date ordered or requested (MCR 7.210[B]). Reporter(s)/recorder(s) shall be paid as provided by law. TRANSCRIPT ORDERED a. Jury trial b. Bench trial c. Plea d. Probation violation plea e. Probation violation hearing f. Sentence g. Resentence REPORTER/RECORDER NAME NUMBER DATE(S) OF PROCEEDING h. Other (specify) 3. The clerk shall immediately send to counsel a copy of the transcripts ordered above or requested by counsel as they become available. The clerk shall also forward documents upon request by counsel (MCR 6.433). Date Judge Bar no. CERTIFICATE OF MAILING I certify that on this date I served a copy of this claim of appeal on the parties or their attorneys by first-class mail addressed to their last-known addresses as defined in MCR 2.107(C)(3). Date CC 403 (3/13) Signature CLAIM OF APPEAL AND ORDER APPOINTING COUNSEL MCR 6.425(G), MCR 6.433, MCR 7.210(B)(3) American LegalNet, Inc. www.FormsWorkFlow.com