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Here is the text we could read:

STATE OF MICHIGAN

PROBATE COURT
COUNTY

PETITION FOR JUDICIAL ADMISSION

CASE NO. and JUDGE

Court address

Court telephone no.

In the matter of

First, middle, and last name

Last four digits of SSN

Name (type or print)

1. I,

State your interest/relationship

2. The individual named above, born

Put DOB in Ref. No.
row 1 on MC 97.
Date

Michigan, and can be found at

, is a resident of

County

, am interested in this matter and make this petition as

Address City, state, zip

a. can be reasonably expected within the near future to intentionally or unintentionally seriously physically injure

3. The individual is a person with an intellectual disability and

self or another person and has overtly acted in a manner substantially supportive of that expectation.

b. has been arrested and charged with an offense that was a result of the intellectual disability.

4. This allegation is based upon:

a. My personal observation of the individual doing the following acts and saying the following things:

Approved, SCAO
Form PCM 224, Rev. 5/21
MCL 330.1516
Page 1 of 2

JIS Code: PJAPut last 4 digits of SSN in Ref. No. row 2 on MC 97.XXX-XX-Petition for Judicial Admission
Page 2 of 2

(5/21)

Case No.

4. b. The following conduct and statements by the individual, which I have been informed others have seen or heard:

Witness name Complete address Telephone no.

5. Persons interested in these proceedings are:

NAME

RELATIONSHIP

ADDRESS

TELEPHONE NO.

6. The individual will not comply with an order for examination because

7. The court order the individual to be examined at

Facility

8. The court order a peace officer to take the individual into protective custody and transport him/her immediately to

for examination.

9. The individual be determined by the court to be a person meeting the criteria for judicial admission for treatment.

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best
of my information, knowledge, and belief.

Name (type or print) Bar no.

Signature of petitioner

Date

Address

City, state, zip Telephone no.

by:

I REQUEST

Facility

Signature of attorney

Address

PCM 224, Petition for Judicial Admission

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/MH-Forms (2023-03)
Page(s): 2
Fields(s): 64
Average fields per page: 32
Reading Level: Grade 8
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

stat_e_f_michiga_n_probat_cour_county was STATE OF MICHIGAN PROBATE COURT COUNTY (0.62 conf)
court_address was Court address (0.42 conf)
first_last_name_individual was First middle and last name of individual (0.35 conf)
note_last_information_form was Note Provide the last 4 digits of the individuals SSN on a personal identifying information form MC 97 (0.37 conf)
name_type_print__1 was Name type or print (0.45 conf)
undefined__1 was undefined (0.38 conf)
county was County (0.39 conf)
expected_intentionally_unintentionally was a can be reasonably expected within the near future to intentionally or unintentionally seriously physically injure (0.36 conf)
arrested_charged_intellectual was b has been arrested and charged with an offense that was a result of the intellectual disability (0.37 conf)
personal_saying_things__1 was a My personal observation of the individual doing the following acts and saying the following things 1 (0.34 conf)
personal_saying_things__2 was a My personal observation of the individual doing the following acts and saying the following things 2 (0.34 conf)
personal_saying_things__3 was a My personal observation of the individual doing the following acts and saying the following things 3 (0.34 conf)
personal_saying_things__4 was a My personal observation of the individual doing the following acts and saying the following things 4 (0.34 conf)
personal_saying_things__5 was a My personal observation of the individual doing the following acts and saying the following things 5 (0.34 conf)
personal_saying_things__6 was a My personal observation of the individual doing the following acts and saying the following things 6 (0.34 conf)
personal_saying_things__7 was a My personal observation of the individual doing the following acts and saying the following things 7 (0.34 conf)
personal_saying_things__8 was a My personal observation of the individual doing the following acts and saying the following things 8 (0.34 conf)
personal_saying_things__9 was a My personal observation of the individual doing the following acts and saying the following things 9 (0.34 conf)
personal_saying_things__10 was a My personal observation of the individual doing the following acts and saying the following things 10 (0.34 conf)
personal_saying_things__11 was a My personal observation of the individual doing the following acts and saying the following things 11 (0.34 conf)
personal_saying_things__12 was a My personal observation of the individual doing the following acts and saying the following things 12 (0.34 conf)
judge was Judge (0.39 conf)
text__1 was Text2 (0.35 conf)
informed_others_seen__1 was 4 b The following conduct and statements by the individual which I have been informed others have seen or heard 1 (0.35 conf)
informed_others_seen__2 was 4 b The following conduct and statements by the individual which I have been informed others have seen or heard 2 (0.35 conf)
witness_name__1 was Witness name (0.46 conf)
telephone__1 was Telephone no (0.44 conf)
complete_address__1 was Complete address 1 (0.33 conf)
complete_address__2 was Complete address 2 (0.33 conf)
witness_name__2 was Witness name_2 (0.41 conf)
telephone__2 was Telephone no_2 (0.45 conf)
name_row__1 was NAMERow1 (0.43 conf)
relationship_row__1 was RELATIONSHIPRow1 (0.39 conf)
address_row__1 was ADDRESSRow1 (0.36 conf)
telephon_e_row__1 was TELEPHONE NORow1 (0.52 conf)
name_row__2 was NAMERow2 (0.43 conf)
relationship_row__2 was RELATIONSHIPRow2 (0.39 conf)
address_row__2 was ADDRESSRow2 (0.36 conf)
telephon_e_row__2 was TELEPHONE NORow2 (0.52 conf)
name_row__3 was NAMERow3 (0.43 conf)
relationship_row__3 was RELATIONSHIPRow3 (0.39 conf)
address_row__3 was ADDRESSRow3 (0.36 conf)
telephon_e_row__3 was TELEPHONE NORow3 (0.52 conf)
name_row__4 was NAMERow4 (0.43 conf)
relationship_row__4 was RELATIONSHIPRow4 (0.39 conf)
address_row__4 was ADDRESSRow4 (0.36 conf)
telephon_e_row__4 was TELEPHONE NORow4 (0.52 conf)
individual_comply_order was 6 The individual will not comply with an order for examination because (0.46 conf)
undefined__2 was undefined_2 (0.39 conf)
undefined__3 was undefined_3 (0.39 conf)
facility__1 was Facility (0.33 conf)
officer_individual_custody was 8 The court order a peace officer to take the individual into protective custody and transport himher immediately to (0.36 conf)
facility__2 was Facility_2 (0.32 conf)
signature_date was Date (1.00 conf)
name_type_print__2 was Name type or print_2 (0.40 conf)
bar was Bar no (0.41 conf)
users1_address_line_one was Address (1.00 conf)
address was Address_2 (0.35 conf)
users1_address_line_two was City state zip (1.00 conf)
telephone__3 was Telephone no_3 (0.45 conf)
city_state_zip was City state zip_2 (0.35 conf)
telephone__4 was Telephone no_4 (0.45 conf)
text__2 was Text3 (0.35 conf)
text__3 was Text4 (0.35 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

PCM 224, Petition for Judicial Admission

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02