þ The State of Michigan THE PEOPLE OF þ vDefendant222s nameCTNSIDDOB Juvenile In the matter of þ TO: þ (Name and address of defendant or parent posting bond.) þ þ þ (Name and address of surety or other depositor posting bond.) þ þ *Use Note: Check this box if the defendant failed to appear and a surety bond was posted. The defendant/juvenile has violated the conditions of bail as described below: Offense(s)Violation(s) nonappearance on other: Full bail amount$Amount of cash deposited$TYPE OF BOND: Personal recognizance 10% cash Cash Surety Real propertyIT IS ORDERED the release is revoked and bond is forfeited. The proceeds of a bond, whether cash, surety, or designated real property, shall be disposed of within 45 days of the date of this order. þ *A hearing is scheduled to show good cause why judgment should not enter against the surety for the full amount of the surety bond on Date and time . Date þ Judge Bar no. þ TO THE DEFENDANT/PARENT AND JUVENILE:You have 28 days from the date of this order to surrender yourself to the court or to satisfy the court that there was compliance with the conditions of release or that compliance was impossible through no fault of the defendant/juvenile. Otherwise, judgment for the full bail amount plus costs will be entered against you. Money or other security on deposit will be used toward payment of the judgment. þ A warrant for your arrest/order to apprehend þ has been þ will be þ issued. þ I certify that on this date I served a copy of this order and notice on the defendant or parent and surety or person who posted bond by first-class mail addressed to their last-known addresses as defined by MCR 2.107(C)(3). Date þ Clerk/Deputy ORDER NOTICE CERTIFICATE OF MAILING American LegalNet, Inc. www.FormsWorkFlow.com