Approved, SCAO Original - Court 1st copy - Arresting agency 2nd copy - Michigan State Police CJIC 3rd copy - Prosecutor 4th copy - Defendant PROBATE JIS CODE: ROF STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT COUNTY CASE NO. ORDER REGARDING DESTRUCTION OF FINGERPRINTS AND ARREST CARD Court telephone no. ORI Court address MI- Police Report No. The State of Michigan THE PEOPLE OF Defendant/Juvenile name, address, and telephone no. v CTN/TCN SID DOB Juvenile In the matter of Count CRIME CHARGE CODE(S) MCL citation/PACC Code 1. Name of defendant/juvenile filed a motion requesting that his/her fingerprints and arrest card be destroyed by the arresting agency and/or Michigan State Police as required by law. 2. A hearing was held on the motion on IT IS ORDERED: Date . 3. In accordance with MCL 28.243, the arresting agency and/or Michigan State Police shall not destroy or return the fingerprints and arrest card of the defendant/juvenile. immediately destroy the fingerprints and arrest card of the defendant/juvenile and provide certification of that fact to the defendant/juvenile. Date Judge Bar no. CERTIFICATE OF MAILING I certify that on this date I served a copy of this order on the parties or their attorneys and, as appropriate, the arresting agency and the Michigan State Police, by first-class mail addressed to their last-known addresses as defined by MCR 2.107(C)(3). Date Signature MC 392 (3/10) ORDER REGARDING DESTRUCTION OF FINGERPRINTS AND ARREST CARD MCL 28.243, MCL 780.621, MCL 780.623, MCR 3.936(D) American LegalNet, Inc. www.FormsWorkFlow.com