Approved, SCAO

STATE OF MICHIGAN

JUDICIAL DISTRICT
JUDICIAL CIRCUIT

ORI
MI-
Police Report No.

THE PEOPLE OF

ORDER FOR FINGERPRINTS

Original - Court
1st copy - Defendant/Attorney
2nd copy - Law enforcement agency

CASE NO.

Court  address

Court  telephone  no.

The State of Michigan

Defendant's/Respondent's name, address, and telephone no.

v

     Juvenile

In the matter of

Arresting agency name and ORI

Incident date

Arrest  date

CTN

PACC Code

USE NOTE:  This order is to be issued when:  1) fingerprints were not taken at arrest and are required to be taken, or  2) the respondent
is found guilty of criminal contempt for violating a personal or valid foreign protection order and fingerprints were not already taken.

IT IS ORDERED:

1.

a. Defendant/Juvenile/Respondent shall go to

Law enforcement agency

so that fingerprints can be taken.

The fingerprints must be taken before

    .

Next scheduled court date

or

b. The sheriff shall take custody of the defendant/juvenile/respondent to take his/her fingerprints.

2. The clerk shall forward immediately a copy of this order with an attached copy of the complaint, petition, or information to the

law enforcement agency required to take fingerprints.

3. Unless otherwise incarcerated, defendant/juvenile/respondent shall be released immediately after his/her fingerprints are taken.

4. Refusal to submit to fingerprinting may subject the defendant/juvenile/respondent to contempt or criminal charges.

Judge/Magistrate

Bar no.

PROOF OF SERVICE

I certify that on this date copies of this order were served on the parties by

first-class mail to their last-known addresses.
personal service.

I certify that arrest data and a set of fingerprints were taken and properly submitted for retention to the Michigan State Police Criminal
Justice Information Center.

TCN (when CTN is not already assigned)

OCA

Court clerk

CERTIFICATE OF FINGERPRINTING

Signature

Name (type or print)

Date

Date

Date

MC 233   (5/07)   ORDER FOR FINGERPRINTS

MCL 28.243, MCL 764.29, MCL 769.1, MCL 769.16a(5), MCR 3.936