Approved, SCAO Original - Court Copies as needed STATE OF MICHIGAN JUDICIAL DISTRICT CASE NO. NOTICE OF INTENT TO FORFEIT AND DISPOSE OF PROPERTY Court telephone no. Court address The People of the State of Michigan The People of In the matter of v Defendant name, address, and telephone no. TO: *This notice must be given to all persons who were sent notice of seizure and intent to forfeit and dispose of property. 1. BE ADVISED that the following real property, personal property, Description , has been determined to have a value of less than $100,000. 2. Not more than 28 days has elapsed since the conviction of a crime by the defendant named above. 3. The State of Michigan of government, seeks forfeiture of the property. , local unit 4. You are given notice of the seizure of the property the filing of a lien against the property and of the intent to begin forfeiture proceedings and to dispose of such property according to law. 5. You have 28 days after receipt of this notice or date of first publication of notice (as marked on the other side) to file a notice of claim of interest in the property described above with the state or local unit of government. Date Signature Name (type or print) DC 45 (3/15) NOTICE OF INTENT TO FORFEIT AND DISPOSE OF PROPERTY American LegalNet, Inc. www.FormsWorkFlow.com MCL 600.4707 PROOF OF SERVICE I certify that on this date a copy of this notice was served upon Name by personal service. certified mail. I declare that this proof of service is true to the best of my information, knowledge, and belief. Date Signature Name (type or print) NOTICE BY PUBLICATION It has been determined that the name and address of the person to whom this notice is directed cannot be reasonably ascertained or delivery of the notice cannot be reasonably accomplished. The notice on the other side was published for at least 10 consecutive publishing days as required by law in a newspaper of general circulation in the county where the property was seized or is located. Proof of publication is attached. Date Signature Name (type or print) American LegalNet, Inc. www.FormsWorkFlow.com