Approved, SCAO Original - Friend of the court 1st copy - Lien recorder Additional copies as needed STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Friend of the court address CASE NO. NOTICE OF LIEN (Claimant's Case Number) Telephone no. TO: Lien recorder Plaintiff's name, address, and telephone no. obligor v FROM: Friend of the Court - Claimant (address above) This lien results from a support order entered registered on by the Circuit Court, Date Defendant's name, address, and telephone no. obligor County, Michigan. This order requires the obligor named above to pay support in the amount of $ per . Obligor's date of birth As of the obligor owes unpaid support in the amount of $ and this lien amount is subject to an interest rate of %. Michigan support orders accrue a surcharge as defined in MCL 552.603a. Prospective amounts of support, not paid when due, are judgments and accrue to the lien amount. This lien attaches to all nonexempt real and personal property of the obligor named above that is located or recorded within the state/county/other subdivision of the state of filing, including any property specifically described as follows: The priority and enforcement aspects of this lien are governed by the law of the state where the property is located. An obligor must follow the laws and procedures of the state where the property is located or recorded to contest or challenge this lien. This lien remains in effect until released by the claimant or in accordance with the laws of the state of filing. Note to Lien Recorder: Please provide the claimant with a copy of the filed lien, containing the recording information, at the address above. As an authorized agent of a state, or subdivision of a state, responsible for implementing the support enforcement program set forth in Title IV, Part D, of the Federal Social Security Act (42 USC 651 et seq.), I have authority to file this support lien in any state or U.S. Territory. For other information regarding this lien, including payoff amount, contact the claimant at the above address. Please reference the above case number. Signature of friend of the court authorized representative Name (type or print) Subscribed and sworn to before me on My commission expires: Date Date , Signature: Notary public Name (type or print) County, Michigan. Notary public, State of Michigan, County of Date served on lien recorder: FOC 90 (3/16) NOTICE OF LIEN MCL 552.625a, MCL 552.625b, MCL 552.2603 American LegalNet, Inc. www.FormsWorkFlow.com