STATE OF MICHIGAN

PROBATE COURT
COUNTY

ORDER TO USE FUNDS
(CONSERVATORSHIP)

CASE NO. and JUDGE

Court address              

 

 

 

Court telephone no.

In the matter of 

First, middle, and last name

Petitioner’s name, address, and telephone no.

Petitioner’s attorney, bar no., address, and telephone no.

A petition for use of funds was filed on 

 .

Date

IT IS ORDERED:

 1. The petition is denied. 

 2. The petition is granted. The conservator is authorized to withdraw $ 
 
    petition. If access to these funds was restricted, access to the remainder of the funds is still restricted. Receipts or 

 from the account stated in the 

 

    proof that the money was spent for the requested purpose shall be filed with this court by 

 .

Date

 
 

 

3. Other:

I certify that I have compared this copy with the original on file in this court and that it is a correct copy of the original.

Judge signature and date

Date

 

Deputy register

Instructions to Financial Institution: Do not accept any document other than a certified copy of this order with the court 
seal. Please retain this certified copy.

Approved, SCAO
Form PC 673o, Rev. 5/21
MCL 700.5427
Page 1 of 1

JIS Code OUF

PC 673o, Order to Use Funds (Conservatorship)

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About This Form:

• Sourced from www.courts.michigan.gov/conservatorship-protected-individuals (2023-03)
• Page(s): 1
• Fields(s): 16
• Average fields per page: 16
• Reading Level: Grade 6
• LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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