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This report should be completed annually by the juvenile guardian, or more often if directed by the court.

In the matter of

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

1. I,

Name (type or print)

my annual report for the period

Date

2. Living Arrangement

a. Current address and telephone number of the child:

b. The child has been in the present residence since
state the changes and the reasons for change:

Date

3. Physical Health

, am the juvenile guardian of the child named above and

Date

is as follows:

. If moved within the past year,

The child’s current physical condition is

During the past year the child received the following medical treatment, including check-ups and optical and dental work.

(Specify each date, ailment, type of treatment, and doctor’s name.)

excellent.

good.

poor.

fair.

4. Mental Health

The child’s current mental condition is
During the past year the child received the following mental health services.

(Specify any prescribed medications, treatment received, and doctor’s name.)

excellent.

good.

fair.

poor.

Approved, SCAO
Form JC 94, Rev. 1/21
MCL 700.5215(f), MCR 3.979(E)(1)
Page 1 of 2

STATE OF MICHIGANJUDICIAL CIRCUIT - FAMILY DIVISIONCOUNTYANNUAL REPORT OF JUVENILE GUARDIANON CONDITION OF CHILDCASE NO.PETITION NO.JUDGECourt addressCourt telephone no.JIS Code: AGMAnnual Report of Juvenile Guardian on Condition of Child
Page 2 of 2

(1/21)

Case No.

5. Education
State whether the child regularly attends school, where the child attends school, and what grade the child attends. If the
child attends alternative education, state where and the grade. If the child does not attend school, explain why.

6. Activities
Describe the child’s involvement in social, religious, and sports activities.

7. Parenting Time
Describe any parenting time between the child and his/her parents. Provide the address for each parent. Describe
anything about the parenting time you believe is important for the court to know.

8. Other
State any information about the child that you believe is important for the court to know, such as special awards or

recognition the child has received, any special needs the child may have not otherwise stated above, any contact with
law enforcement or child protective services, etc.

Signature of juvenile guardian

Date

Address

City, state, zip Telephone no.

JC 94, Annual Report of Juvenile Guardian On Condition of Child

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/juvenile-guardianship-forms (2023-03)
Page(s): 2
Fields(s): 48
Average fields per page: 24
Reading Level: Grade 9
LIST Grouping(s): HE-00-00-00-00, ES-03-00-00-00, ES-05-00-00-00, FA-00-00-00-00.

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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)
first_last_name was First and last name of childrenjuvenile (0.35 conf)
report_completed_often was This report should be completed annually by the juvenile guardian or more often if directed by the court (0.36 conf)
guardian_child_named was am the juvenile guardian of the child named above and (0.38 conf)
signature_date__1 was Date (1.00 conf)
undefined__1 was undefined (0.38 conf)
current_address_number was a Current address and telephone number of the child (0.37 conf)
state_changes_reasons_change was state the changes and the reasons for change (0.36 conf)
excellent__1 was excellent (0.32 conf)
good__1 was good (0.45 conf)
fair__1 was fair (0.32 conf)
poor__1 was poor (0.41 conf)
unknown__1 was 1 (0.38 conf)
unknown__2 was 2 (0.38 conf)
unknown__3 was 3 (0.38 conf)
unknown__4 was 4 (0.38 conf)
excellent__2 was excellent_2 (0.35 conf)
good__2 was good_2 (0.39 conf)
fair__2 was fair_2 (0.39 conf)
poor__2 was poor_2 (0.34 conf)
prescribed_medications_treatment__1 was Specify any prescribed medications treatment received and doctors name 1 (0.38 conf)
prescribed_medications_treatment__2 was Specify any prescribed medications treatment received and doctors name 2 (0.38 conf)
prescribed_medications_treatment__3 was Specify any prescribed medications treatment received and doctors name 3 (0.38 conf)
prescribed_medications_treatment__4 was Specify any prescribed medications treatment received and doctors name 4 (0.38 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)
education_grade_school__1 was child attends alternative education state where and the grade If the child does not attend school explain why 1 (0.37 conf)
education_grade_school__2 was child attends alternative education state where and the grade If the child does not attend school explain why 2 (0.37 conf)
education_grade_school__3 was child attends alternative education state where and the grade If the child does not attend school explain why 3 (0.37 conf)
describe_involvement_social__1 was Describe the childs involvement in social religious and sports activities 1 (0.35 conf)
describe_involvement_social__2 was Describe the childs involvement in social religious and sports activities 2 (0.35 conf)
describe_involvement_social__3 was Describe the childs involvement in social religious and sports activities 3 (0.35 conf)
describe_involvement_social__4 was Describe the childs involvement in social religious and sports activities 4 (0.35 conf)
anything_time_know__1 was anything about the parenting time you believe is important for the court to know 1 (0.37 conf)
anything_time_know__2 was anything about the parenting time you believe is important for the court to know 2 (0.37 conf)
anything_time_know__3 was anything about the parenting time you believe is important for the court to know 3 (0.37 conf)
anything_time_know__4 was anything about the parenting time you believe is important for the court to know 4 (0.37 conf)
law_enforcement_child__1 was law enforcement or child protective services etc 1 (0.43 conf)
law_enforcement_child__2 was law enforcement or child protective services etc 2 (0.43 conf)
law_enforcement_child__3 was law enforcement or child protective services etc 3 (0.43 conf)
undefined__2 was undefined_2 (0.39 conf)
signature_date__2 was Date_2 (1.00 conf)
users1_address_line_one was Address (1.00 conf)
text__4 was Text6 (0.35 conf)
text__5 was Text7 (0.35 conf)

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

JC 94, Annual Report of Juvenile Guardian On Condition of Child

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