Approved, SCAO Original - Court 1st copy - Plaintiff/Attorney 2nd copy - Defendant/Attorney 3rd copy - Seizing agency STATE OF MICHIGAN JUDICIAL DISTRICT NOTICE OF SEIZURE OF PERSONAL PROPERTY SUBJECT TO FORFEITURE WITHOUT PROCESS AND ORDER CASE NO. Court address Court telephone no. The People of the State of Michigan The People of In the matter of NOTICE 1. I am the attorney general prosecuting attorney Description Defendant name, address, and telephone no. v city/township attorney for and I state: 2. The following personal property was seized . 3. The property was seized at Location . . Name (type or print) 4. The owner of the property is believed to be 5. The property was seized without process because a. it is the proceeds of a crime, the substituted proceeds of a crime, or instrumentality of a crime and was seized incident to a lawful arrest. b. the seizure is under a valid search warrant. c. the seizure is under a valid inspection warrant. d. there is probable cause to believe the property is directly or indirectly dangerous to public health or safety. e. exigent circumstances exist and there is probable cause to believe that the property is the proceeds of a crime, the substituted proceeds of a crime, or an instrumentality of a crime. f. the property is subject to a prior judgment in favor of the state in an earlier forfeiture proceeding. 6. It is believed a. the property is contraband. b. the ownership of the property is disputed. c. the property is required to be held as evidence. Date Signature Name (type or print) ORDER 7. THE COURT FINDS seizure of the property without process was appropriate inappropriate reasons: IT IS ORDERED: 8. The property described above shall remain under seal in the custody of the seizing agency . 9. The property described above shall be removed and stored at Location for the following Name and location . 10. The property described above shall be returned promptly to Name (type or print) Date Judge Bar no. MCL 600.4703(2) . American LegalNet, Inc. www.FormsWorkFlow.com DC 40 (3/15) NOTICE OF SEIZURE OF PERSONAL PROPERTY SUBJECT TO FORFEITURE WITHOUT PROCESS AND ORDER