THE PEOPLE OF

 The State of Michigan

 
 

Offense(s)

Name and address of surety or other depositor posting bond

Defendant’s name, address, and telephone no.

v

CTN/TCN

SID

Amount of bail bond forfeited
$

Date of forfeiture judgment

TYPE OF BOND:                

 Personal recognizance

              

 10% bond         

 Cash             

 Surety 

 

 Real property

MOTION

 on 

Date

 , 

 i.  The forfeited surety bond was fully paid to the court on 

 , within 56 days of the entry of 

Date

 ii.  The forfeited surety bond has not been fully paid and defendant was apprehended within 56 days of the entry of 

 a. The county’s costs of apprehension are $ 
  
 
 b. The county has no apprehension costs. 

4. 
 
 
5. I request that the forfeiture order be set aside and that the judgment amount of $ 

 and  

 have 

 

 

 

 have not  

  been paid in full.

  

 be returned to

Signature of surety/depositor/attorney

NOTICE OF HEARING

Name of surety or other depositor

 .

   

Date

A hearing on the above motion will be held on 

Date and time

  at 

Location

 .

Date
If you require accommodations to use the court because of disabilities or if you require a foreign language interpreter to help 
you fully participate in court proceedings, please contact the court immediately to make arrangements.

Signature

 

 

1. The defendant was apprehended by 

 Agency

  within 1 year of the date of forfeiture judgment.

2. The ends of justice have not been thwarted.

  a. cash, checks, or securities.
  b. a surety bond.

3. The forfeited bond is:
    
    
         
 
         
 

            the forfeiture judgment.

            the forfeiture judgment.

STATE OF MICHIGANJUDICIAL DISTRICTJUDICIAL CIRCUITCOUNTY MOTION TO SET ASIDE FORFEITURE AND DISCHARGE OF BOND AND NOTICE OF HEARINGCASE NO. and JUDGEORIMI-Court addressCourt telephone no.Approved, SCAOForm MC 399, Rev. 4/22MCL 765.15, MCL 765.22, MCL 765.28, MCL 780.67, MCR  6.106(I)Page 1 of 2Distribute form to:CourtProsecutorDefendantSurety or other depositorMotion to Set Aside Forfeiture and Discharge of Bond and Notice of Hearing 
Page 2 of 2

(4/22) 

Case No. 
 

CERTIFICATE OF MAILING

I served a copy of this motion and notice of hearing on the parties or their attorneys and the surety or other depositor by 
first-class mail addressed to their last-known addresses as defined by MCR 2.107(C)(3). 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

 

Signature