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Here is the text we could read:

STATE OF MICHIGAN

JUDICIAL CIRCUIT
COUNTY

DOMESTIC RELATIONS
JUDGMENT INFORMATION 
 FINAL

 TEMPORARY 

 

To the Clerk:  For FOC office

CASE NO. and JUDGE

Friend of the court address

Telephone no.

USE NOTE: Complete this form and file it with the friend of the court when the first temporary custody, parenting-time, or 
support order is entered and when submitting any final proposed judgment awarding custody, parenting time, or support. 
Mail a copy to each party and file proof of mailing with the court (may use form MC 302, Proof of Mailing).

The information previously provided 

 

 is changed. 

 

 is unchanged. 

 

(Complete only the fields that have changed.)

 

Plaintiff Information
Name

Date

Address

Defendant Information
Name

Signature

Address

Social security number

Telephone number

Social security number Telephone number

E-mail address

E-mail address

Employer name, address, telephone number, and FEIN (if known)

Employer name, address, telephone number, and FEIN (if known)

Driver’s license number and state

Driver’s license number and state

Occupational license number(s), type(s), issuing state(s), and date(s)

Occupational license number(s), type(s), issuing state(s), and date(s)

CUSTODY PROVISIONS 

 

  sole, plaintiff = P  sole, defendant = D 

joint = J  other = O 

(must identify)

Child’s name

Date of birth

Child’s primary residence address

Social 
security
number

Physical
custody
P, D, J, O

Legal
custody
P, D, J, O

Approved, SCAO
Form FOC 100, Rev. 6/22
MCR 3.211(F)
Page 1 of 2

Distribute form to: 
Friend of the Court
All parties

Domestic Relations Judgment Information 
Page 2 of 2

(6/22) 

Case No. 
 

SUPPORT PROVISIONS

 Support provisions are stated in the Uniform Support Order.

MEDICAL SUPPORT PROVISIONS: List the name of each insurance provider for the plaintiff and the defendant. Then 
enter the name of each child in this case who is covered by that provider and the type of coverage provided.

Plaintiff’s Insurance Coverage
Provider name and address

Policy/Group no.

Cert. no. Child(ren)’s name(s)

Medical Dental Optical Other

Defendant’s Insurance Coverage
Provider name and address

Policy/Group no.

Cert. no. Child(ren)’s name(s)

Medical Dental Optical Other

FOC 100, Domestic Relations Judgment Information

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/Domestic-Relations (2023-03)
Page(s): 2
Fields(s): 133
Average fields per page: 66
Reading Level: Grade 8
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

temporary was TEMPORARY (0.50 conf)
final was FINAL (0.40 conf)
changed was is changed (0.32 conf)
unchanged was is unchanged (0.36 conf)
signature_date was Date (1.00 conf)
users1_name was Name (1.00 conf)
name was Name_2 (0.30 conf)
users1_address_line_one was Address (1.00 conf)
address was Address_2 (0.35 conf)
social_security_number__1 was Social security number (0.38 conf)
telephone_number__1 was Telephone number (0.42 conf)
social_security_number__2 was Social security number_2 (0.39 conf)
telephone_number__2 was Telephone number_2 (0.38 conf)
users1_email was Email address (1.00 conf)
email_address was Email address_2 (0.41 conf)
employer_name_address_number__1 was Employer name address telephone number and FEIN if known (0.45 conf)
employer_name_address_number__2 was Employer name address telephone number and FEIN if known_2 (0.40 conf)
drivers_license_number_state__1 was Drivers license number and state (0.50 conf)
drivers_license_number_state__2 was Drivers license number and state_2 (0.51 conf)
license_issuing_dates__1 was Occupational license numbers types issuing states and dates (0.41 conf)
license_issuing_dates__2 was Occupational license numbers types issuing states and dates_2 (0.44 conf)
must_identify was must identify (0.36 conf)
childs_name_row__1 was Childs nameRow1 (0.33 conf)
social_security_number_row__1 was Social security numberRow1 (0.38 conf)
date_birth_row__1 was Date of birthRow1 (0.37 conf)
physical_custody_p_j_row__1 was Physical custody P D J ORow1 (0.44 conf)
primary_residence_address__1 was Childs primary residence addressRow1 (0.34 conf)
legal_custody_p_j_row__1 was Legal custody P D J ORow1 (0.41 conf)
childs_name_row__2 was Childs nameRow2 (0.33 conf)
social_security_number_row__2 was Social security numberRow2 (0.38 conf)
date_birth_row__2 was Date of birthRow2 (0.37 conf)
physical_custody_p_j_row__2 was Physical custody P D J ORow2 (0.44 conf)
primary_residence_address__2 was Childs primary residence addressRow2 (0.34 conf)
legal_custody_p_j_row__2 was Legal custody P D J ORow2 (0.41 conf)
childs_name_row__3 was Childs nameRow3 (0.33 conf)
social_security_number_row__3 was Social security numberRow3 (0.38 conf)
date_birth_row__3 was Date of birthRow3 (0.37 conf)
physical_custody_p_j_row__3 was Physical custody P D J ORow3 (0.44 conf)
primary_residence_address__3 was Childs primary residence addressRow3 (0.34 conf)
legal_custody_p_j_row__3 was Legal custody P D J ORow3 (0.41 conf)
childs_name_row__4 was Childs nameRow4 (0.33 conf)
social_security_number_row__4 was Social security numberRow4 (0.38 conf)
date_birth_row__4 was Date of birthRow4 (0.37 conf)
physical_custody_p_j_row__4 was Physical custody P D J ORow4 (0.44 conf)
primary_residence_address__4 was Childs primary residence addressRow4 (0.34 conf)
legal_custody_p_j_row__4 was Legal custody P D J ORow4 (0.41 conf)
circuit was Circuit (0.33 conf)
county was County (0.39 conf)
judge was Judge (0.39 conf)
telephone was Telephone no (0.44 conf)
friend_court_address was Friend of the court address (0.41 conf)
text was Text5 (0.35 conf)
provider_name_address_row__1 was Provider name and addressRow1 (0.42 conf)
policy_group_row__1 was PolicyGroup noRow1 (0.49 conf)
cert_row__1 was Cert noRow1 (0.40 conf)
childrens_names_row__1 was Childrens namesRow1 (0.37 conf)
provider_name_address_row__2 was Provider name and addressRow2 (0.42 conf)
policy_group_row__2 was PolicyGroup noRow2 (0.49 conf)
cert_row__2 was Cert noRow2 (0.40 conf)
childrens_names_row__2 was Childrens namesRow2 (0.37 conf)
provider_name_address_row__3 was Provider name and addressRow3 (0.42 conf)
policy_group_row__3 was PolicyGroup noRow3 (0.49 conf)
cert_row__3 was Cert noRow3 (0.40 conf)
childrens_names_row__3 was Childrens namesRow3 (0.37 conf)
provider_name_address_row__4 was Provider name and addressRow4 (0.42 conf)
policy_group_row__4 was PolicyGroup noRow4 (0.49 conf)
cert_row__4 was Cert noRow4 (0.40 conf)
childrens_names_row__4 was Childrens namesRow4 (0.37 conf)
provider_name_address_row__5 was Provider name and addressRow5 (0.42 conf)
policy_group_row__5 was PolicyGroup noRow5 (0.49 conf)
cert_row__5 was Cert noRow5 (0.40 conf)
childrens_names_row__5 was Childrens namesRow5 (0.37 conf)
provider_name_address_row__6 was Provider name and addressRow1_2 (0.46 conf)
policy_group_row__6 was PolicyGroup noRow1_2 (0.47 conf)
cert_row__6 was Cert noRow1_2 (0.36 conf)
childrens_names_row__6 was Childrens namesRow1_2 (0.35 conf)
provider_name_address_row__7 was Provider name and addressRow2_2 (0.46 conf)
policy_group_row__7 was PolicyGroup noRow2_2 (0.47 conf)
cert_row__7 was Cert noRow2_2 (0.36 conf)
childrens_names_row__7 was Childrens namesRow2_2 (0.35 conf)
provider_name_address_row__8 was Provider name and addressRow3_2 (0.46 conf)
policy_group_row__8 was PolicyGroup noRow3_2 (0.47 conf)
cert_row__8 was Cert noRow3_2 (0.36 conf)
childrens_names_row__8 was Childrens namesRow3_2 (0.35 conf)
provider_name_address_row__9 was Provider name and addressRow4_2 (0.46 conf)
policy_group_row__9 was PolicyGroup noRow4_2 (0.47 conf)
cert_row__9 was Cert noRow4_2 (0.36 conf)
childrens_names_row__9 was Childrens namesRow4_2 (0.35 conf)
provider_name_address_row__10 was Provider name and addressRow5_2 (0.46 conf)
policy_group_row__10 was PolicyGroup noRow5_2 (0.47 conf)
cert_row__10 was Cert noRow5_2 (0.36 conf)
childrens_names_row__10 was Childrens namesRow5_2 (0.35 conf)
support_provisions_stated was Support provisions are stated in the Uniform Support Order (0.42 conf)
medical__1 was Medical1 (0.35 conf)
medical__2 was Medical10 (0.35 conf)
medical__3 was Medical9 (0.35 conf)
medical__4 was Medical8 (0.35 conf)
medical__5 was Medical7 (0.35 conf)
medical__6 was Medical6 (0.35 conf)
medical__7 was Medical5 (0.35 conf)
medical__8 was Medical4 (0.35 conf)
medical__9 was Medical3 (0.35 conf)
medical__10 was Medical2 (0.35 conf)
dental__1 was Dental1 (0.35 conf)
optical__1 was Optical1 (0.35 conf)
other1 was Other1 (0.35 conf)
dental__2 was Dental2 (0.35 conf)
optical__2 was Optical2 (0.35 conf)
other2 was Other2 (0.35 conf)
dental__3 was Dental3 (0.35 conf)
optical__3 was Optical3 (0.35 conf)
other3 was Other3 (0.35 conf)
dental__4 was Dental4 (0.35 conf)
optical__4 was Optical4 (0.35 conf)
other4 was Other4 (0.35 conf)
dental__5 was Dental5 (0.35 conf)
optical__5 was Optical5 (0.35 conf)
other5 was Other5 (0.35 conf)
dental__6 was Dental6 (0.35 conf)
optical__6 was Optical6 (0.35 conf)
other6 was Other6 (0.35 conf)
dental__7 was Dental7 (0.35 conf)
optical__7 was Optical7 (0.35 conf)
other7 was Other7 (0.35 conf)
dental__8 was Dental8 (0.35 conf)
optical__8 was Optical8 (0.35 conf)
other8 was Other8 (0.35 conf)
dental__9 was Dental9 (0.35 conf)
optical__9 was Optical9 (0.35 conf)
other9 was Other9 (0.35 conf)
dental__10 was Dental10 (0.35 conf)
optical__10 was Optical10 (0.35 conf)
other10 was Other10 (0.35 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

temporary
final
changed
unchanged
signature_date
users1_name
name
users1_address_line_one
address
social_security_number__1
telephone_number__1
social_security_number__2
telephone_number__2
users1_email
email_address
employer_name_address_number__1
employer_name_address_number__2
drivers_license_number_state__1
drivers_license_number_state__2
license_issuing_dates__1
license_issuing_dates__2
must_identify
childs_name_row__1
social_security_number_row__1
date_birth_row__1
physical_custody_p_j_row__1
primary_residence_address__1
legal_custody_p_j_row__1
childs_name_row__2
social_security_number_row__2
date_birth_row__2
physical_custody_p_j_row__2
primary_residence_address__2
legal_custody_p_j_row__2
childs_name_row__3
social_security_number_row__3
date_birth_row__3
physical_custody_p_j_row__3
primary_residence_address__3
legal_custody_p_j_row__3
childs_name_row__4
social_security_number_row__4
date_birth_row__4
physical_custody_p_j_row__4
primary_residence_address__4
legal_custody_p_j_row__4
circuit
county
judge
telephone
friend_court_address
text
provider_name_address_row__1
policy_group_row__1
cert_row__1
childrens_names_row__1
provider_name_address_row__2
policy_group_row__2
cert_row__2
childrens_names_row__2
provider_name_address_row__3
policy_group_row__3
cert_row__3
childrens_names_row__3
provider_name_address_row__4
policy_group_row__4
cert_row__4
childrens_names_row__4
provider_name_address_row__5
policy_group_row__5
cert_row__5
childrens_names_row__5
provider_name_address_row__6
policy_group_row__6
cert_row__6
childrens_names_row__6
provider_name_address_row__7
policy_group_row__7
cert_row__7
childrens_names_row__7
provider_name_address_row__8
policy_group_row__8
cert_row__8
childrens_names_row__8
provider_name_address_row__9
policy_group_row__9
cert_row__9
childrens_names_row__9
provider_name_address_row__10
policy_group_row__10
cert_row__10
childrens_names_row__10
support_provisions_stated
medical__1
medical__2
medical__3
medical__4
medical__5
medical__6
medical__7
medical__8
medical__9
medical__10
dental__1
optical__1
other1
dental__2
optical__2
other2
dental__3
optical__3
other3
dental__4
optical__4
other4
dental__5
optical__5
other5
dental__6
optical__6
other6
dental__7
optical__7
other7
dental__8
optical__8
other8
dental__9
optical__9
other9
dental__10
optical__10
other10

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

FOC 100, Domestic Relations Judgment Information

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02