Approved,  SCAO

STATE OF MICHIGAN

JUDICIAL CIRCUIT
COUNTY

JUDGMENT AFTER BOND FORFEITURE
(DOMESTIC RELATIONS)

Original - Court
1st copy - Plaintiff
2nd copy - Defendant
3rd copy - Friend of the court

CASE NO.

Court  address

Court  telephone  no.

Plaintiff's name, address, and telephone no.

Defendant's name, address, and telephone no.

v

Attorney:

Attorney:

TO:

(Name  and  address  of  payer.)

(Name and address of surety or other depositor posting
bond.)

Face amount or value of bond Amount deposited
$

$

TYPE OF BOND:

 Cash

Surety

1. The above bond was forfeited and the payer was ordered to surrender to the court within 28 days.  The payer failed to surrender

as ordered.  IT IS ORDERED:  Judgment is entered in the full face amount or value of the payer's bond as follows.

FOR:

AGAINST:

Unit of government

Payer/Surety/Depositor

Full face amount/value of bond .............. $
Costs
................................................ $
Total amount of judgment ..................... $
Less deposit ......................................... $
Balance of judgment ......................... $

The balance of this judgment must be paid by

Date
If the balance is not paid by this date, any allowed
methods of collection will be pursued.

        .

2. Contempt/show-cause proceedings, for which bond was posted, are still pending.
A bench warrant has been issued in connection with those proceedings.

Date

Date

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

Judge

CERTIFICATE OF MAILING

Bar no.

CC 89   (3/08)   JUDGMENT AFTER BOND FORFEITURE (DOMESTIC RELATIONS)

MCR 3.221(J)(2)

Clerk of the court/Deputy