Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - Friend of the court Approved, SCAO STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY CASE NO. JUDGMENT AFTER BOND FORFEITURE (DOMESTIC RELATIONS) Court address Court telephone no. Defendant's name, address, and telephone no. Plaintiff's name, address, and telephone no. v Attorney: Attorney: TO: (Name and address of payer.) (Name and address of surety or other depositor posting bond.) Face amount or value of bond Amount deposited $ $ TYPE OF BOND: Cash Surety 1. The above bond was forfeited and the payer was ordered to surrender to the court within 28 days. The payer failed to surrender as ordered. IT IS ORDERED: Judgment is entered in the full face amount or value of the payer's bond as follows. FOR: Unit of government AGAINST: Payer/Surety/Depositor Full face amount/value of bond .............. $ Costs ................................................ $ Total amount of judgment ..................... $ Less deposit ......................................... $ Balance of judgment ......................... $ The balance of this judgment must be paid by . Date If the balance is not paid by this date, any allowed methods of collection will be pursued. 2. Contempt/show-cause proceedings, for which bond was posted, are still pending. A bench warrant has been issued in connection with those proceedings. Date Judge Bar no. CERTIFICATE OF MAILING I certify that on this date I served a copy of this judgment on the parties or their attorneys by first-class mail addressed to their lastknown addresses as defined in MCR 2.107(C)(3). Date CC 89 (3/08) Clerk of the court/Deputy JUDGMENT AFTER BOND FORFEITURE (DOMESTIC RELATIONS) MCR 3.221(J)(2) American LegalNet, Inc. www.FormsWorkflow.com