Plaintiff’s name, address, and telephone no.                      

 payer

Attorney:
             v
Defendant’s name, address, and telephone no.                 

 payer

1. The files in this case have been reviewed and it
    has been determined that there is an arrearage
    of: 

Attorney:

license.

 b. An order of income withholding is not applicable or has been unsuccessful in ensuring regular payments on the 
        support obligation and regular payments on the arrearage. Notice of a proposed license suspension was sent to 
        the payer, and at least 21 days have passed since the notice was sent. The payer requested a hearing on the 
        proposed license suspension but failed to appear and has failed to pay the arrearage in full.

 a. An order of income withholding is not applicable or has been unsuccessful in ensuring regular payments on the 
        support obligation and regular payments on the arrearage. Notice of a proposed license suspension was sent to 
        the payer, and at least 21 days have passed since the notice was sent. The payer has failed to pay the arrearage 
        in full or request a hearing on the proposed license suspension.

2. The payer holds driver’s, occupational, recreational, and/or sporting licenses or is in an occupation that requires a 
 
3. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4. The friend of the court requests the court to issue an order directing that the payer’s driver’s, occupational, recreational, 
  and/or sporting licenses be suspended by the licensing agency and occupational regulatory agency.

 c.  The payer was found in contempt of court and the court entered an order conditionally suspending the payer’s
        license(s) and scheduling the payment of the arrearage. The payer failed to comply with the arrearage payment
        schedule, was given notice and an opportunity for a hearing, and failed to respond.

        license(s) and scheduling the payment of the arrearage. The payer failed to comply with the arrearage payment 
        schedule.

 d. Notice of a proposed license suspension was sent to the payer and the payer has requested a hearing on the 

 e. At a hearing on the proposed suspension, the court entered an order conditionally suspending the payer’s 

        proposed suspension.

CERTIFICATE OF MAILING
I served a copy of this motion on the parties or their attorneys by first-class mail addressed to their last-known addresses 
as defined by MCR 3.203. I declare under the penalties of perjury that this certificate of mailing has been examined by me 
and that its contents are true to the best of my information, knowledge, and belief.

 

 

Date

Date

Approved, SCAO
Form FOC 81, Rev. 3/21
MCL 552.628, MCL 552.633(2)
Page 1 of 1

Friend of the court

Signature  

 

 

Distribute form to: 
Court 
Plaintiff 
Defendant 
Friend of the court

STATE OF MICHIGANJUDICIAL CIRCUITCOUNTYMOTION TO SUSPEND LICENSECASE NO. and JUDGECourt addressCourt telephone no.MOTION