Approved, SCAO JIS CODE: LOG STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION CASE NO. LETTERS OF JUVENILE GUARDIANSHIP Court telephone no. COUNTY Court address In the matter of name, alias(es), DOB TO: Name and address Juvenile guardian's telephone no. 1. You have been appointed as juvenile guardian of the child named above. 2. Having filed an acceptance of appointment, you have the care, custody, and control of the child, together with all authority and responsibilities granted and imposed by MCL 700.5215 and MCR 3.979. 3. Other: (Specify restrictions or limitations.) You shall not move the child's residence from the State of Michigan without a court order. Date Judge Bar no. I certify that I have compared this copy with the original on file and that it is a correct copy of the whole of such original, and on this date, these letters are in full force and effect. Date Clerk/Deputy clerk NOTICE OF REPORTING DUTIES You are required to file with this court written reports as follows: CHANGE OF ADDRESS: You are required to keep the court and interested persons informed in writing within 7 days of any change in your address. ANNUAL REPORT: Your annual report on the condition of the child is due on of each year. In addition, you must serve the report on the child and interested persons as specified in the Michigan Court Rules and file proof of service with the court. DEATH OF MINOR: If a minor dies during the guardianship, you must file written notice with the court within 14 days of the minor's date of death. The above provisions are reporting duties only and are not the only duties required of you. See MCL 700.5215 and MCR 3.979(B) for the authority and duties of a juvenile guardian. Do not write below this line - For court use only JC 93 (9/10) LETTERS OF JUVENILE GUARDIANSHIP American LegalNet, Inc. www.FormsWorkFlow.com MCR 3.979(B)(2)