Approved,  SCAO

STATE OF MICHIGAN

Original - Circuit court
1st  copy  -  District  court/agency

2nd copy - Appellee
3rd copy - Appellant

CASE NO.

JUDICIAL CIRCUIT
COUNTY

ORDER ON APPLICATION
FOR LEAVE TO APPEAL

Court  address

Plaintiff's name, address, and telephone no.

Defendant's name, address, and telephone no.

Appellant
Appellee

v

Court  telephone  no.

Appellant
Appellee

Plaintiff's attorney, bar no., address, and telephone no.

Defendant's attorney, bar no., address, and telephone no.

Date:

IT IS ORDERED:

2. Other:

1. The appellant's application for leave to appeal is

granted.          denied.

Judge:

Bar no.

Date

Judge

I certify that on this date I served a copy of this order on the parties or their attorneys and on the trial court or agency by first-class
mail addressed to their last-known addresses as defined by MCR 2.107(C)(3).

CERTIFICATE OF MAILING

Date

Court clerk

CC 299   (3/13)   ORDER ON APPLICATION FOR LEAVE TO APPEAL

MCR 7.105(D)



Order on Application for Leave to Appeal

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About This Form:

• Sourced from www.courts.michigan.gov/appeals (2023-03)
• Page(s): 1
• Fields(s): 24
• Average fields per page: 24
• Reading Level: Grade 9
• LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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