Approved, SCAO STATE OF MICHIGAN PROBATE COURT COUNTY JIS CODE: PAO FILE NO. PETITION AND ORDER CIRCUIT COURT - FAMILY DIVISION In the matter of 1. I am interested in this matter and make this petition as . State interest/relationship 2. The interested persons, addresses, and their representatives are identical to those appearing on the initial application/petition, except as follows: (for each person whose address changed, list the name and new address; attach separate sheet if necessary) 3. I state: (state facts) 4. I REQUEST that: I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Petitioner signature Attorney signature Name (type or print) Bar no. Address Petitioner name (type or print) Address City, state, zip Telephone no. City, state, zip Telephone no. ORDER IT IS ORDERED that the above petition is Date granted. denied. granted in part as follows: Judge Bar no. Do not write below this line - For court use only PC 586 (9/05) PETITION AND ORDER MCR 5.113 American LegalNet, Inc. www.FormsWorkflow.com