Approved, SCAO JIS CODE: WNH STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY Court address WAIVER OF SUMMONS/NOTICE OF HEARING CASE NO. PETITION NO. Court telephone no. 1. In the matter of name(s), alias(es), DOB 2. A hearing is scheduled for Date Type of hearing at Time m. regarding . 3. I have received a copy of the petition for the hearing scheduled above. 4. I understand that this hearing may result in either a temporary suspension or a permanent loss of my parental rights to the minor(s). 5. I understand that: a. In a juvenile delinquency proceeding, the juvenile has the right to remain silent and is not obligated to testify. b. The juvenile has a right to a court-appointed attorney if the juvenile and those responsible for his/her support are financially unable, or refuse, to provide an attorney. c. The respondent has the right to a court-appointed attorney, if charged with an offense against the child and financially unable to hire an attorney. d. I have the right to bring witnesses on my behalf and confront and examine those testifying against me. e. I have the right to a jury at trial only, there is no right to a jury at a termination hearing. If I want a jury trial, I must file a request in writing with the court within: 1) 14 days after the court gives notice of the right to jury trial, or 2) 14 days after an appearance by an attorney, whichever is later, but no later than 21 days before trial. 6. I acknowledge this notice and my right to receive a summons or written notice of hearing. I knowingly, voluntarily, and understandingly waive service of a summons. further legal notice of this hearing. Date Juvenile's signature Address City, state, zip Mother's signature Address City, state, zip Father's signature Address City, state, zip Signature Address City, state, zip Relationship Do not write below this line - For court use only JC 23 (9/14) WAIVER OF SUMMONS/NOTICE OF HEARING MCR 3.911, MCR 3.915, MCR 3.920(F) American LegalNet, Inc. www.FormsWorkFlow.com