COURT OUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... .. Approved, SCAO : STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Index No. CASE NO. Calendar No. DISMISSAL OF :PRISONER CIVIL ACTION, Frivolous Action Plaintiff(s) Court address Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - SCAO -against- : JUDICIAL SUBPOENA Court telephone no. : Plaintiff name and address Defendant name and address : : v Prisoner number Defendant(s) : ................................................... Plaintiff's attorney, bar no., address, and telephone no. Defendant's attorney, bar no., address, and telephone no. E PEOPLE OF THE STATE OF NEW YORK THE COURT FINDS: 1. The REETINGS: plaintiff filed a complaint on concerning prison conditions. Date 2. The plaintiff YOU, that all business and excuses to pay the filing fee and costs of you by law. WE COMMAND was determined indigent and unable being laid aside, you and eachrequiredattend before , Honorable at the Court Full filing fee of $ was waived. Partial filing fee of $ was waived. located at unty of oom , on the day of , 20 , at o'clock in the noon, and at any recessed An attorney was appointed. adjourned date, to testify and give evidence as a witness in this action on the part of the 3. The plaintiff was determined indigent and shall pay the filing fee and costs as required by MCL 600.2963. 4. Total unpaid fees and costs to date are: $ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 5. The complaint or a portion of the complaint is frivolous as follows: ult of your failure to comply. Witness, Honorable urt in IT IS ORDERED: County, , one of the Justices of the day of , 20 6. The civil action is dismissed with prejudice as a frivolous action and the following unpaid fees and costs shall be paid by the plaintiff in accordance with this order. (Attorney must sign above and type name below) Filing Fee Other Costs (specify) Attorney Fees Total $ $ $ $ Attorney(s) for Payments toward the unpaid fees and costs shall be as follows: Office and P.O. Address 7. The good time/disciplinary credits accumulated by the plaintiff as of the following amount: all all up to days. shall be forfeited in Date Telephone No.: Facsimile No.: Judge Bar no. Date E-Mail Address: A copy of this order shall be promptly mailed to the State Court Administrative Office. Mobile Tel. No.: MCL 600.5501 et seq.; MSA 27A.5501 et seq., CC 78 (5/00) DISMISSAL OF PRISONER CIVIL ACTION, Frivolous Action American LegalNet, Inc. www.USCourtForms.com MCL 800.33 et seq.