STATE OF MICHIGAN

CASE NO. and JUDGE

PROBATE COURT
COUNTY

DECLARATION OF INTENT TO
GIVE NOTICE BY PUBLICATION

Court address              

 

 

 

Court telephone no.

In the matter of 

First, middle, and last name

Service of 

specify document(s)

 cannot be made on

Name                                                                                                                     Address

                                                                                                              City                                                                       State                      Zip

I intend to publish notice on this individual because his/her address or whereabouts are unknown. I have made the following

diligent efforts to ascertain his/her address or whereabouts: 

 
 

 

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

 

 

Petitioner signature   

 

 

Attorney signature

NOTE: Complete a separate Declaration of Intent to Give Notice by Publication (PC 617) for each person to be notified 
by publication. After publication, file a completed Proof of Service (PC 564), including an affidavit of publication, with the 
court.

 

 

 

 

 

Date

Date

Approved, SCAO
Form PC 617, Rev. 12/22
MCR 5.105(A)(3)
Page 1 of 1

Petitioner’s name, address and telephone no.Petitioner’s attorney, bar no., address, and telephone no.JIS Code: DOI