STATE OF MICHIGAN

JUDICIAL DISTRICT
JUDICIAL CIRCUIT
COUNTY PROBATE

Court address              
 

   

 

 

CONTACT INFORMATION

 AMENDED

CASE NO. and JUDGE

 

 

 

 

 

 

 

Court telephone no.

This form is confidential and not to be served on other parties in this case.  Any contact information below that 
has already been provided or is provided in the future in a public court filing or through the MiFILE system will 
not be made confidential by this document. 

Please provide the following contact information:

1. Your name:  

First, middle, and last name

2. 
 
 

 a.  Telephone number where the court can contact me: 
 can 
 can 

        This telephone: 
                       
 
          

 cannot 
 cannot 

 
 

 
 

 

 

 

receive text messages from the court.
receive voice messages from the court. 

   

 b. I do not have a telephone number where the court can contact me.

3. 

  a. E-mail address where I can receive e-mails: 

 

 

 b.  I do not have an e-mail address where I can receive e-mails from the court.

 

 

PLEASE READ AND UNDERSTAND THE FOLLOWING:
Upon signing this form, you are consenting to text, e-mail, and/or phone notifications on your court case.  If the case is NON-PUBLIC, it is NOT ELIGIBLE 
for text or phone notifications.  

By signing this form, I authorize the 

Name of court

 court to notify me of upcoming events in this case.  

I understand, based on the options chosen above that I will receive text, e-mail, and/or voice notifications to the phone 

number or e-mail address listed on this form.  I also understand that the 

 court is not 

Name of court

responsible for any additional fees or charges due to my phone carrier data rates.  

In the event that my e-mail, or cell or land line phone number changes, I will notify the court to update their records, and if 
I fail to do so it will result in the termination of this service from the court.  

Privacy Disclaimer:  Your contact information is necessary to assist the court in providing important information in a timely 
manner.  Your information will not be sold, distributed, or shared with any other entity.  You can OPT-OUT of the system at 
any time.  Simply reply OPTOUT to any received message.

Date

 

Signature  

 

 

Approved, SCAO
Form MC 505, Rev. 9/22
MCR 2.407(D)
Page 1 of 1

JIS Code: CIF