In the matter of 

First and last name(s), alias(es)

1. Date of hearing: 
2. Notice of hearing was served as required by law.

 

 

  Judge/Referee: 

 3. Removal date: 

 

 (Under MCR 3.963.)

THE COURT FINDS: (Complete items 5 and 6 if the child is being removed at this hearing.)

 4. It is in the best interest of the child to terminate the appointment of 
    A proposed successor juvenile guardian has been named.
 5. It is contrary to the welfare of the child to remain in the juvenile guardian’s home because:

Name of juvenile guardian

 

 .

 6. 
   

 a. Reasonable efforts to prevent removal of the child from the home were not made.
 b. Reasonable efforts were made to prevent removal of the child from the home. Those efforts include: (Specify.)

IT IS ORDERED:

 7. The appointment of the juvenile guardian named above is continued.
 8. The appointment of the juvenile guardian named above is terminated, and the juvenile guardian 
    discharged.

 

 is 

 

 is not 

    The current placement of the child shall continue pending appointment of 

Name (type or print)

   

Address                                                                      City                           State         Zip                      Telephone no.

 as successor guardian.

    The department shall
    a. conduct a criminal record check and central registry clearance of the residents of the home of the proposed 
        successor juvenile guardian and submit the results to the court within 7 days.
    b. perform a home study with a copy submitted to the court within 28 days, unless a home study has been performed
        within the immediately preceding 365 days of this order, in which case, a copy of that home study shall be submitted
        to the court.

 

                     

Recommended by: 

Referee signature and date

 

                     

Judge signature and date

USE NOTE: This form is used in conjunction with JC 98 only when a proposed successor juvenile guardian has been named in the petition; if a successor 
juvenile guardian has not been named, use JC 101 instead. This form should not be used to terminate the appointment of one guardian when there are 
coguardians for a single child; use JC 104 instead.

Reference Note: The term “department” refers to the Michigan Department of Health and Human Services.

Approved, SCAO
Form JC 100, Rev. 10/20
MCR 3.979(F)
Page 1 of 1

STATE OF MICHIGANJUDICIAL CIRCUIT - FAMILY DIVISIONCOUNTYORDER FOLLOWING HEARING ONPETITION TO TERMINATE APPOINTMENT OF JUVENILE GUARDIANCASE NO.PETITION NO.JUDGECourt addressCourt telephone no.JIS Code: OTG