Original - Officer return 1st copy - Court 2nd copy - Defendant 3rd copy - Plaintiff Approved, SCAO STATE OF MICHIGAN JUDICIAL DISTRICT APPLICATION AND ORDER OF EVICTION Landlord-Tenant / Land Contract Court address CASE NO. Court telephone no. Defendant name(s) and address(es) Plaintiff name, address, and telephone no. v Plaintiff's attorney, bar no., address, and telephone no. APPLICATION 1. On judgment was entered against the defendant(s) and the plaintiff was awarded Date possession of the following described property: 2. No payment has been made on the judgment or no rent has been received since the date of judgment, except the sum of $ received under the following conditions: 3. The plaintiff has complied with the terms of the judgment. 4. The time stated in the judgment before an order of eviction can be issued has elapsed. I declare that the statements above are true to the best of my information, knowledge, and belief. Plaintiff/Attorney signature Date ORDER OF EVICTION IN THE NAME OF THE PEOPLE OF THE STATE OF MICHIGAN: To the Court Officer: You are ordered to restore the plaintiff to, and put the plaintiff in, full possession of the premises. Date issued SEAL Judge Bar no. NOTE: In tenancy cases, this order must be served within 56 days of the issuance date. DC 107 (3/09) APPLICATION AND ORDER OF EVICTION, Landlord-Tenant / Land Contract MCL 600.5744, MCR 4.201(L), MCR 4.202(K) American LegalNet, Inc. www.FormsWorkFlow.com RETURN I certify and return that on I executed the order of eviction on the reverse side of this form Date by evicting Name(s) from the property, and I have restored the plaintiff to peaceful possession as ordered. Date Service fee $ (Deputy) sheriff/Court officer/Bailiff Miles traveled Fee $ Incorrect address fee Miles traveled Fee TOTAL FEE $ $ $ American LegalNet, Inc. www.FormsWorkFlow.com