Approved, SCAO Original - Court 1st copy - Prosecutor 2nd copy - Defendant 3rd copy - Surety or other depositor STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT ORI CASE NO. ORDER ON MOTION TO SET ASIDE FORFEITURE AND DISCHARGE OF BOND Court telephone no. Court address MI- THE PEOPLE OF The State of Michigan v Defendant name, address, and telephone no. CTN SID DOB Name and address of surety or other depositor posting bond Offense(s) *Amount of bail bond forfeited $ Date of forfeiture judgment TYPE OF BOND: 10% bond* Personal recognizance Cash Surety* Real property 1. Date of hearing: Date Judge: Bar no. THE COURT FINDS: 2. The requirements of MCL 765.28 3. The costs of apprehension are $ IT IS ORDERED: 4. The motion is denied. 5. The bond forfeiture is set aside and the bond is discharged. Assessment of costs of apprehension in the amount of $ shall be deducted from the judgment pursuant to MCL 765.15. shall be returned to the surety/depositor. have have not and been met. have have not been paid. 6. Judgment in the amount of $ 7. Other: Date Judge Bar no. CERTIFICATE OF SERVICE I certify that on this date I served a copy of this order on the plaintiffs or their attorneys by personal service. first-class mail addressed to their last-known address(es) as defined in MCR 2.107(C)(3). Date MC 399a (3/12) Signature ORDER ON MOTION TO SET ASIDE FORFEITURE AND DISCHARGE OF BOND MCL 765.15, MCL 765.22, MCL 765.28, MCL 780.66, MCL 780.67, MCR 6.106(I) American LegalNet, Inc. www.FormsWorkFlow.com