Defendant’s/Juvenile’s name, address, and telephone no.

v

CTN/TCN

SID

THE PEOPLE OF

 The State of Michigan

 
 

In the matter of 
 

1. I, 

Name (type or print)

MOTION

 , was arrested and a DNA sample was taken from me, and

 
 

 the offense(s) charged against me in this case was/were dismissed.
 I was acquitted of all offenses(s) charged against me in this case.

2. To my knowledge, the arresting agency and the Michigan State Police have not destroyed the DNA profile and sample.

3. I REQUEST that my DNA profile and sample be destroyed by the arresting agency and Michigan State Police.

Date

Signature  

 

 

A hearing will be held on this motion on 

Date and time

Location

before Hon. 

NOTICE OF HEARING

 at 

 .

 

If you require accommodations to use the court because of a disability or if you require a foreign language interpreter to help 
you fully participate in court proceedings, please contact the court immediately to make arrangements.

CERTIFICATE OF MAILING

I served a copy of this motion on the parties or their attorneys by first-class mail addressed to their last-known addresses 
as defined by MCR 2.107(C)(3). I declare under the penalties of perjury that this certificate of mailing has been examined 
by me and that its contents are true to the best of my information, knowledge, and belief.

Date

Signature  

 

 

 

 

STATE OF MICHIGANJUDICIAL DISTRICTJUDICIAL CIRCUITCOUNTY MOTION TO DESTROYDNA PROFILE AND SAMPLECASE NO. and JUDGEORIMI-Court addressCourt telephone no.Police Report No.Approved, SCAOForm MC 443, Rev. 1/21MCL 28.176Page 1 of 1Distribute form to:CourtProsecutorDefendant/Juvenile