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STATE OF MICHIGAN

JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY

CLAIM OF APPEAL AND ORDER
APPOINTING APPELLATE COUNSEL

Substitution of Counsel
Order Amended

CASE NO.

PETITION NO.

JUDGE

Court address

Court telephone no.

In the matter of

First and last name(s), alias(es)

Name(s) of child(ren) affected by the order being appealed

Name and address of petitioner

Name and phone number of lawyer-guardian ad litem for child(ren)

1. The respondent,

Date

Michigan by Judge

Name (one respondent per claim of appeal)

, claims an appeal from an order entered

in the

Circuit Court,

County,

.
.

The order being appealed is an:

a. order removing a child from a parent’s care and custody.
b. initial order of disposition following adjudication in a child protective proceeding.
c. order terminating parental rights.
d. order of disposition placing a minor under the supervision of the court in a delinquency proceeding.
e. order involving an Indian child appealable under MCR 3.993(A)(6).
f. other final order or order required by law to be appealed to the Court of Appeals.

Copies of the judgment or order being appealed and the register of actions in the case are attached for the Court of Appeals, appointed counsel,

the respondent filed a request for appointment of attorney and a declaration of indigency.

Name Address

City, state, zip Telephone no. Bar no.

is appointed counsel for the respondent in appellate proceedings. If appointed counsel cannot or will not accept this

appointment, counsel shall notify the court immediately.

petitioner, and prosecutor.

2. On

Date

IT IS ORDERED:

Approved, SCAO
Form JC 84, Rev. 3/21
25 USC 1912, MCR 3.993, MCR 7.204, MCR 7.210(B)(3)
Page 1 of 2

Distribute form to:
Trial Court
Court Reporter(s)/Recorder(s)
Appointed Attorney
Respondent
Petitioner
Prosecutor
Lawyer-Guardian Ad Litem
Court of Appeals
Indian tribe (if applicable)

JIS Code: COAClaim of Appeal and Order Appointing Appellate Counsel
Page 2 of 2

(3/21)

Case No.

4. The court reporter(s)/recorder(s) shall file with the trial court clerk the transcripts listed below and any other transcripts
requested by counsel in this case not previously transcribed. Transcripts shall be filed within 42 days from the date

ordered or requested in a custody case, or 91 days in other cases. MCR 7.210(B). Reporter(s)/Recorder(s) shall be
compensated for the transcripts as provided by law.

REPORTER/RECORDER NAME

NUMBER

DATE(S) OF PROCEEDING

The clerk shall immediately send to counsel a copy of the transcripts ordered above or requested by counsel as they
become available.

Judge signature and date

Note: This order must be served on the respondent, appointed counsel for the respondent, court reporter(s)/recorder(s),
petitioner, prosecuting attorney, Indian tribe (if any), lawyer-guardian ad litem, and guardian ad litem or attorney (if any) for
the child(ren). Service may be made by first-class mail. Use form JC 12a or JC 12b for proof of service and attach it to this
order before sending it to the Court of Appeals.

To deny appointment of appellate counsel, use form JC 85.

JC 84, Claim of Appeal and Order Appointing Appellate Counsel

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About This Form:

Sourced from www.courts.michigan.gov/appeals (2023-03)
Page(s): 2
Fields(s): 53
Average fields per page: 26
Reading Level: Grade 8
LIST Grouping(s): CO-00-00-00-00, CO-07-00-00-00.

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.

stat_e_n_l_county was STATE OF MICHIGAN JUDICIAL CIRCUIT FAMILY DIVISION COUNTY (0.64 conf)
appointin_g_appellat_e_counsel was APPOINTING APPELLATE COUNSEL (0.52 conf)
first_last_name was First and last name (0.40 conf)
children_affected_order was Names of children affected by the order being appealed (0.41 conf)
name_address_petitioner was Name and address of petitioner (0.32 conf)
phone_number_ad was Name and phone number of lawyerguardian ad litem for children (0.36 conf)
name_one_respondent_claim_appeal was Name one respondent per claim of appeal (0.48 conf)
signature_date__1 was Date (1.00 conf)
in_the was in the (0.31 conf)
circuit_court was Circuit Court (0.40 conf)
actions_case_appeals was Copies of the judgment or order being appealed and the register of actions in the case are attached for the Court of Appeals (0.43 conf)
signature_date__2 was Date_2 (1.00 conf)
users1_name was Name (1.00 conf)
users1_address_line_one was Address (1.00 conf)
users1_address_line_two was City state zip (1.00 conf)
telephone was Telephone no (0.44 conf)
bar was Bar no_2 (0.37 conf)
text__1 was Text1 (0.35 conf)
petition was Petition no (0.49 conf)
judge was Judge (0.39 conf)
text__2 was Text4 (0.35 conf)
text__3 was Text5 (0.35 conf)
substitution_counsel was Substitution of Counsel (0.43 conf)
checkbox__1 was checkbox101 (0.35 conf)
checkbox__2 was checkbox102 (0.35 conf)
checkbox__3 was checkbox203 (0.35 conf)
checkbox__4 was checkbox104 (0.35 conf)
checkbox__5 was checkbox100 (0.35 conf)
checkbox__6 was checkbox105 (0.35 conf)
reporterrecorde_r_name_row__1 was REPORTERRECORDER NAMERow1 (0.44 conf)
number_row__1 was NUMBERRow1 (0.38 conf)
date_f_proceeding_row__1 was DATES OF PROCEEDINGRow1 (0.43 conf)
reporterrecorde_r_name_row__2 was REPORTERRECORDER NAMERow2 (0.44 conf)
number_row__2 was NUMBERRow2 (0.38 conf)
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number_row__3 was NUMBERRow3 (0.38 conf)
date_f_proceeding_row__3 was DATES OF PROCEEDINGRow3 (0.43 conf)
reporterrecorde_r_name_row__4 was REPORTERRECORDER NAMERow4 (0.44 conf)
number_row__4 was NUMBERRow4 (0.38 conf)
date_f_proceeding_row__4 was DATES OF PROCEEDINGRow4 (0.43 conf)
reporterrecorde_r_name_row__5 was REPORTERRECORDER NAMERow5 (0.44 conf)
number_row__5 was NUMBERRow5 (0.38 conf)
date_f_proceeding_row__5 was DATES OF PROCEEDINGRow5 (0.43 conf)
reporterrecorde_r_name_row__6 was REPORTERRECORDER NAMERow6 (0.44 conf)
number_row__6 was NUMBERRow6 (0.38 conf)
date_f_proceeding_row__6 was DATES OF PROCEEDINGRow6 (0.43 conf)
reporterrecorde_r_name_row__7 was REPORTERRECORDER NAMERow7 (0.44 conf)
number_row__7 was NUMBERRow7 (0.38 conf)
date_f_proceeding_row__7 was DATES OF PROCEEDINGRow7 (0.43 conf)
reporterrecorde_r_name_row__8 was REPORTERRECORDER NAMERow8 (0.44 conf)
number_row__8 was NUMBERRow8 (0.38 conf)
date_f_proceeding_row__8 was DATES OF PROCEEDINGRow8 (0.43 conf)

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

JC 84, Claim of Appeal and Order Appointing Appellate Counsel

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