Claim Of Appeal Of Right Or Request To Withdraw Admission And Order Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Claim Of Appeal Of Right Or Request To Withdraw Admission And Order Form. This is a Michigan form and can be use in Civil Statewide.
Tags: Claim Of Appeal Of Right Or Request To Withdraw Admission And Order, CIA 05, Michigan Statewide, Civil
Original - Court
1st copy - Defendant
2nd copy - Prosecutor
3rd copy - Defendant (order)
Approved, SCAO
STATE OF MICHIGAN
JUDICIAL DISTRICT
CLAIM OF APPEAL OF RIGHT/
REQUEST TO WITHDRAW ADMISSION
AND ORDER, Civil Infraction
CASE NO.
Court address
Court telephone no.
Plaintiff
The
Defendant's name and address
State
Township
City
Village
v
of
Statute
Ordinance
Infraction:
Infraction date:
SECURITY FOR APPEAL/REQUEST TO WITHDRAW ADMISSION
This is the plaintiff's appeal; no security is required.
Bond is set at $
.
Fine and costs of $
Bond was posted
were paid on
.
Date
.
Date
CLAIM OF APPEAL OF RIGHT
Plaintiff
Defendant
claims an appeal from the judgment entered on
Date
in this court, by the
traffic bureau.
magistrate.
district judge.
Applicant signature
Date
Address
City, state, zip
REQUEST TO WITHDRAW ADMISSION
Defendant requests to withdraw the admission entered on
in this court, by the
Date
traffic bureau.
magistrate.
district judge.
Date
Defendant signature
Address
City,state, zip
ORDER REGARDING REQUEST TO WITHDRAW ADMISSION
IT IS ORDERED the defendant's request to withdraw is
Date
CIA 05 (4/08)
granted.
denied.
Judge/Magistrate
MCR 4.101(G), (H)(3)
CLAIM OF APPEAL OF RIGHT/REQUEST TO WITHDRAW ADMISSION AND ORDER, Civil Infraction
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