Original - Court 1st copy - Defendant/Juvenile 2nd copy - Surety or other depositor Approved, SCAO STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT ORI CASE NO. JUDGMENT AFTER BOND FORFEITURE Court address Court telephone no. MI- THE PEOPLE OF Defendant name The State of Michigan v SID CTN Juvenile DOB In the matter of TO: Name and address of defendant/parent posting bond Name and address of surety or other depositor posting bond Offense(s) *Full bail amount $ Amount of cash deposited TYPE OF BOND: 10% cash* $ Personal recognizance Cash Surety* Real property 1. The above bond was forfeited and the defendant was ordered to surrender to the court within 28 days. The defendant/juvenile failed to surrender as ordered. IT IS ORDERED: Judgment is entered in the full bail amount as follows: FOR: Unit of government AGAINST: Defendant/Parent/Surety/Depositor Full bail amount ................................. Plus costs ......................................... Total amount of judgment ................. Less amount of cash deposited Balance of judgment ............... *If a 10% bond is allowed by the court and a surety bond for one quarter of the full bail amount has been posted by a surety under MCL 765.6(2), judgment against the surety is limited to that one quarter. The remaining three quarters of the full bail amount plus costs are the responsibility of the defendant/parent, less the amount of cash deposited. The balance of this judgment must be paid by . If it is not paid within 56 days of this date, a 20% late Date penalty on the amount owed will be applied to the balance and any allowed methods of collection will be pursued. 2. a. The original charge(s) against the defendant/juvenile, for which the forfeited bond was posted, is/are still pending. A bench warrant/order to apprehend has been issued on the original charge(s). b. Fine and costs as ordered have not been paid. A bench warrant/order to apprehend was issued for failure to comply with judgment and bond posted to ensure appearance. Contempt/show-cause proceedings, for which bond was posted, are still pending. Date Judge Bar no. CERTIFICATE OF MAILING I certify that on this date copies of this judgment were served on the defendant or parent and surety or person who posted bond by first-class mail addressed to the last-known addresses as defined by MCR 2.107(C)(3). Date MC 238 (3/09) JUDGMENT AFTER BOND FORFEITURE Clerk/Deputy MCL 765.15, MCL 765.22, MCL 780.66, MCL 780.67, MCR 6.106(I) American LegalNet, Inc. www.FormsWorkFlow.com