In the matter of 

Party A

 and 

Party B

Party A’s address and telephone no.

Party B’s address and telephone no.

Party A’s attorney, bar no., address, and telephone no.

Party B’s attorney, bar no., address, and telephone no.

In the name of the people of the State of Michigan:

1. A proposed consent judgment/order has been presented to the court for entry.

2. The court will hold a hearing to enter this judgment/order on:

  Date and time: 

 

  Location: 

 

  The hearing will be held in accordance with MCR 3.210(E) after any applicable statutory waiting period has concluded. 
  Both  parties must be present for this hearing in accordance with MCR 3.223(D).

3. If either party objects to this summary proceeding at any time before entry of the proposed consent judgment/order, the 
  case will be dismissed.

4. This notice was issued on 

Date

 .

Note: This document must be sealed by the seal of the court. Party A is responsible for serving this document on the other 
party in accordance with MCR 2.103 and MCR 2.105. 

Approved, SCAO
Form CCFD 26, Rev. 12/21
MCR 3.223(C)(3)(a)
Page 1 of 2

Distribute form to: 
Court file
Party A 
Party B 
Friend of the court

STATE OF MICHIGANJUDICIAL CIRCUIT - FAMILY DIVISIONCOUNTYNOTICE OF REQUEST TO ENTER CONSENT JUDGMENT/ORDERCASE NO. and JUDGECourt addressCourt telephone no.Notice of Request to Enter Consent Judgment/Order 
Page 2 of 2

(12/21) 

Case No. 
 

CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE

 I served 

 

 personally 

 

 by registered or certified mail (copy of return receipt attached)

  a copy of the notice of request to enter consent judgment/order, and the attachments listed below on: 

 I have attempted to serve the notice of request to enter consent judgment/order, together with the attachments listed 

  below, and have been unable to complete service on:

Party B’s name

Date and time of service

Place or address of service

Attachments (if any)

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

Note: If documents are served by someone other than a sheriff, deputy sheriff, or other person listed in MCL 600.1910(b), this return must be notarized.

                     

 
Service fee
$
 

                     
Incorrect address fee
$
                     

 

Miles traveled

Miles traveled

Fee
$

Fee
$

Subscribed and sworn to before me on 
 
 

                     
                     

Date

My commission expires on 
 
Notary public, State of Michigan, County of 

                     

 

 

  
Signature

  
Name (type or print)

  
Title (if applicable)

TOTAL FEE
$

 

 

 

 

 

 

 

 

Deputy clerk/Notary public signature

 . 

Name (type or print)
 

 

 . 

 Acting in the County of 

 

 

 

 

 

 

 

 This notarial act was performed using an electronic notarization system or a remote electronic notarization platform.

 . 
 

 .

I acknowledge that I have received service of the notice of request to enter consent judgment/order, together with

ACKNOWLEDGMENT OF SERVICE

Attachments

Signature

 on 

Date and time

 on behalf of