Original - Court 1st copy - Center 3rd copy - Prosecuting official Approved, SCAO 2nd copy - Defense 4th copy - Sheriff STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT ORDER FOR EVALUATION JUDICIAL CIRCUIT RELATIVE TO CRIMINAL RESPONSIBILITY ORI Court address Court telephone no.MI- The State of Michigan Defendants name, address, and telephone no. THE PEOPLE OF v CTN SID DOB CHARGE CODE(S) Count CRIME MCL citation/PACC Code Date of hearing: Judge: Bar no.Based upon a motion for evaluation relative to criminal responsibility, IT IS ORDERED: 1. The defendant shall undergo an examination, relating to his or her criminal responsibility, by personnel of: the Center for Forensic Psychiatry. other: A written report shall be submitted to this court within 60 days from the date of this order with copies submitted to the prosecuting official and defense attorney, whose names and addresses are: Prosecuting officials name, address, bar no., and telephone no. Defendant attorneys name, address, bar no., and telephone no. 2. If the defendant is on bond, s/he shall appear for examination at the places and times established by the examining facility. If the defendant, after being notified, fails to appear for examination, the court may order detention for examination without hearing. This detention shall end upon completion of the examination. 3. If the defendant is under detention, the facility may perform the examination in jail or may notify the sheriff to transport the defendant to the facility for examination, and the sheriff shall return the defendant to the jail upon completion of the examination.4. The prosecuting official shall immediately provide police investigation reports and criminal history to the facility. 5. Defendant shall cooperate fully and provide access to medical and psychiatric history. 6. Additional orders: Date Judge MC 206 (6/03) ORDER FOR EVALUATION RELATIVE TO CRIMINAL RESPONSIBILITY MCR 6.304