Proof Of Service Oral Notice Regarding Personal Protection Order
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Proof Of Service Oral Notice Regarding Personal Protection Order Form. This is a Michigan form and can be use in Personal Protection Statewide.
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Tags: Proof Of Service Oral Notice Regarding Personal Protection Order, CC 386, Michigan Statewide, Personal Protection
Original - Court file
Copies as needed
Approved, SCAO
STATE OF MICHIGAN
JUDICIAL CIRCUIT
COUNTY
PROOF OF SERVICE/ORAL NOTICE
REGARDING
PERSONAL PROTECTION ORDER
CASE NO.
Court address
Court telephone no.
Petitioner's name
Respondent's name, address, and telephone no.
v
Address and telephone no. where court can reach petitioner
AFFIDAVIT OF SERVICE
I certify that on
I personally served
Date
Respondent name
at
Address or location of service
with a copy of the personal protection order issued on
by the
Date
Circuit Court.
Law enforcement agency
Officer signature
Name (type or print)
ID no.
Address
City, state, zip
Subscribed and sworn to before me on
Telephone no.
,
County, Michigan.
Date
My commission expires:
Signature:
Deputy court clerk/Notary public
Date
Notary public, State of Michigan, County of
PROOF OF ORAL NOTICE
I certify that on
I orally notified
Date
of
Respondent name
the existence of a personal protection order issued on
by the
Date
Circuit Court. I also certify that the respondent was advised of the following:
• the specific conduct enjoined.
• the penalties for violating the order.
• where the respondent could obtain a copy of the personal protection order.
Date
Officer signature
Name (type or print)
ID no.
Law enforcement agency
Address
City, state, zip
Telephone no.
MCL 600.2950(22), MCL 600.2950a(19), MCR 3.706(E)
CC 386 (3/11)
PROOF OF SERVICE/ORAL NOTICE REGARDING PERSONAL PROTECTION ORDER
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