STATE OF MICHIGAN

CASE NO. and JUDGE

PROBATE COURT
COUNTY

SAFE-DEPOSIT BOX
CERTIFICATE AND RECEIPT

Court address              

 

 

 

Court telephone no.

In the matter of 

First, middle, and last name

CERTIFICATE

 1. The undersigned certify that they were present on this date at the opening of the safe-deposit box number 

 

 

 , and

Name of institution

    located in 

   
    a. they   

 

 

 did     

 did not 

find a will of the decedent;

    b. they   

 did     

 did not 

find a deed to a burial plot in which decedent is to be buried;

    c.  no item or items, other than the deed or will, were removed from the safe-deposit box.

 2. No safe-deposit box was located.

Date

 

Signature of others present, if any:

Signature of person named in order to examine contents of box

Signature

Signature of officer or authorized employee of institution 

Signature

 

 

REGISTER’S RECEIPT

Person named in order to examine contents of box

3. I acknowledge receipt from 

  of the following items:

 a. will of the decedent.

 b. burial plot deed.

Approved, SCAO
Form PC 552, Rev. 12/22
MCL 700.2517
Page 1 of 1

 

                     

Deputy probate register signature and date

 

 
 

 

 

 

 

JIS Code: DBC

PC 552, Safe-Deposit Box Certificate and Receipt

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About This Form:

• Sourced from www.courts.michigan.gov/Estates-Trusts (2023-03)
• Page(s): 1
• Fields(s): 22
• Average fields per page: 22
• Reading Level: Grade 7
• LIST Grouping(s): ES-00-00-00-00, ES-02-00-00-00.

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