Approved, SCAO Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - Friend of the court STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court address CASE NO. SUPPORT ENFORCEMENT ORDER (PAGE 1) Court telephone no. Plaintiff's name, address, and telephone no. 1. Date of hearing: Judge/Referee: Bar no. Attorney: v Defendant's name, address, and telephone no. Respondent: FINDINGS: 2. a. The court adopts the findings reported by the referee. b. The court has stated its findings on the record. c. The order is the result of a consent. Attorney: 3. The respondent is not in contempt. 4. The respondent failed to appear as ordered. 5. Costs associated with this proceeding are as follows: Hearing $ Bench warrant $ Arrest $ Further hearings $ Other $ Total costs $ 6. The respondent is in contempt of court for a. failure to appear. b. failure to pay out of currently available resources all or some portion of the amount due. c. failure to exercise due diligence so that he/she could have the capacity to pay all or some portion of the amount due. d. failure to obtain or maintain health-care coverage for the child(ren). e. failure to pay the ordered share of unreimbursed health-care expenses. f. failure to obtain a source of income and failure to participate in a work activity after referral by the friend of the court. g. failure to satisfy the conditions of the commitment order. h. other: 7. As of Date , the respondent owes $ in past-due support (subject to audit). 8. Other: American LegalNet, Inc. www.FormsWorkFlow.com FOC 6 (3/15) SUPPORT ENFORCEMENT ORDER, PAGE 1 MCL 552.511(1)(b), MCL 552.601 et seq., MCR 3.208(B)(4) Approved, SCAO Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - Friend of the court STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court address CASE NO. SUPPORT ENFORCEMENT ORDER (PAGE 2) Court telephone no. Plaintiff's name Defendant's name v IT IS ORDERED: 9. Both parties shall notify the friend of the court in writing of: a) their mailing and residential addresses and telephone numbers; b) the names, addresses, and telephone numbers of their sources of income; c) their health-maintenance or insurance companies, insurance coverage, persons insured, or contract numbers; d) their occupational or drivers' licenses; and e) their social security numbers unless exempt by law pursuant to MCL 552.603. Both parties shall notify the friend of the court in writing within 21 days of any change in this information. Failure to do so may result in a fee being imposed. 10. Participation in work activity is required. is not required for good cause as stated on the record. 11. A bench warrant shall issue for the respondent's arrest with a $ cash-performance bond, which includes $ for the costs of this hearing, issuance of a bench warrant, and arrest. A law enforcement agency is authorized to render any vehicle owned by the payer temporarily inoperable, by booting or another similar method, subject to release on the cash-performance bond described above. 12. The hearing on the Reasons: 13. The bench warrant is discharged. authorization for bench warrant is set aside. bench warrant show cause is adjourned to . 14. The order to show cause is set aside. 15. The respondent is assessed costs of $ , payable to the friend of the court. 16. The respondent shall be assessed statutory surcharge. 17. The respondent is assessed a fee of $ for failure to report required information to the friend of the court. 18. Cash-performance bond in the amount of $ court to be applied to the support account. 19. $ is forfeited and shall be transmitted to the friend of the shall be refunded to the person who posted the bond. 20. The respondent shall submit to the friend of the court on a basis written reports of his/her efforts to find employment and all income received from any source during the reporting period. The reporting shall begin on Date Date . , the respondent shall pay $ for current support, $ monthly. This sum is composed of for overdue support, $ for service fees, and $ for other. for uninsured 21. Beginning $ medical expenses, $ 22. The respondent shall provide proof to the friend of court within days that health-care coverage has been obtained/ maintained. 23. The friend of the court shall notify the appropriate employer, insurer, or plan administrator to enroll the child(ren) for health-care coverage and to deduct premiums. American LegalNet, Inc. www.FormsWorkFlow.com FOC 6 (3/15) SUPPORT ENFORCEMENT ORDER, PAGE 2 MCL 552.511(1)(b), MCL 552.601 et seq., MCR 3.208(B)(4) Approved, SCAO Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - Friend of the court STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court address CASE NO. SUPPORT ENFORCEMENT ORDER (PAGE 3) Court telephone no. Plaintiff's name Defendant's name v 24. Income withholding in the amount of $ 25. The respondent shall be committed to monthly shall start immediately. days in the county jail. The respondent may be released upon payment of $ to the county sheriff, friend of the court, or clerk of the court as appropriate. The sum shall be applied as directed by the friend of the court. The respondent may be released as provided in the attached commitment order. Commitment is stayed according to the terms of the commitment order. 26. The respondent's license(s) will be suspended unless there is compliance with an order for payment of arrearage. 27. The respondent shall be immediately enrolled in a job-placement program and shall fully participate until employed and income withholding is effective. 28. A law enforcement agency shall place an immobilizing device on any vehicle owned by the payer. 29. The respondent is placed under the supervision of the friend of the court office for days with the following conditions or as provided in the attached order of supervision: 30. Other: (Attach additional sheets if necessary.) Date Plaintiff signature Date Judge Defendant signature Date American LegalNet, Inc. www.FormsWorkFlow.com FOC 6 (3/15) SUPPORT ENFORCEMENT ORDER, PAGE 3 MCL 552.511(1)(b), MCL 552.601 et seq., MCR 3.208(B)(4)