Approved, SCAO JIS CODE: OTG STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY Court address ORDER FOLLOWING HEARING ON PETITION TO TERMINATE APPOINTMENT OF JUVENILE GUARDIAN CASE NO. Court telephone no. 1. In the matter of name, alias(es), DOB 2. Date of hearing: 3. Notice of hearing was served as required by law. 4. Removal date: THE COURT FINDS: Judge/Referee: Bar no. (Under MCR 3.963.) (Complete items 6 and 7 if the child is being removed at this hearing.) 5. It is in the best interest of the child to terminate the appointment of Name of juvenile guardian A proposed successor juvenile guardian has been named. 6. It is contrary to the welfare of the child to remain in the juvenile guardian's home because: . 7. a. Reasonable efforts to prevent removal of the child from the home were not made. b. Reasonable efforts were made to prevent removal of the child from the home. Those efforts include: (Specify.) IT IS ORDERED: 8. The appointment of the juvenile guardian named above is continued. 9. The appointment of the juvenile guardian named above is terminated, and the juvenile guardian The current placement of the child shall continue pending appointment of Name (type or print) is is not discharged. as successor guardian. Address City State Zip Telephone no. The department shall a. conduct a criminal record check and central registry clearance of the residents of the home of the proposed successor juvenile guardian and submit the results to the court within 7 days. b. perform a home study with a copy submitted to the court within 28 days, unless a home study has been performed within the immediately preceding 365 days of this order, in which case, a copy of that home study shall be submitted to the court. Recommended by: Referee signature Date Date Judge USE NOTE: This form is used in conjunction with JC 98 only when a proposed successor juvenile guardian has been named in the petition; if a successor juvenile guardian has not been named, use JC 101 instead. This form should not be used to terminate the appointment of one guardian when there are coguardians for a single child; use JC 104 instead. Do not write below this line - For court use only American LegalNet, Inc. www.FormsWorkFlow.com Reference Note: The term "department" refers to the Department of Health and Human Services. JC 100 (9/15) MCR 3.979(F) ORDER FOLLOWING HEARING ON PETITION TO TERMINATE APPOINTMENT OF JUVENILE GUARDIAN