Here is the text we could read:
Distribution: Original - Circuit court
1st copy - Minor (Notice of appeal to circuit court)
2nd copy - Minor (Claim of appeal to Court of Appeals)
3rd copy - Minor (Claim of appeal to
circuit court)
4th copy - Minor
Approved, SCAO
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
APPEAL OF ORDER DENYING
PETITION FOR WAIVER OF
PARENTAL CONSENT
FILE NO.
In the matter of the petition of
, a minor, for waiver of parental consent for an abortion
Initials
NOTICE OF RIGHT TO TIMELY APPEAL
1. An order denying your petition for waiver of parental consent to an abortion was issued by the family division of this court on
Date
at
Time
. A copy of the order is attached.
2. You have a right to appeal to the Court of Appeals this order denying your petition.
3. If you want to appeal, you must complete the notice of appeal at the bottom of this form and file it in the family division of this
circuit court within 24 hours of the date and time stated in item 1 above.
4. If you file the notice of appeal on time, an attorney will be appointed to represent you or you may hire your own attorney.
5. Bring all four copies of this form with you when you file. After you file the notice of appeal, the court will return three copies of
this form to you for use by you and your attorney in claiming your appeal.
6. Within 72 hours (excluding Sundays and holidays) after filing the notice of appeal on time, your attorney must file with the Court
of Appeals the claim of appeal on the other side of this notice along with a copy of the order appealed from. A copy of the claim
of appeal must also be filed with the family division of this circuit court. See MCR 3.615 for details for perfecting an appeal
and filing the brief on appeal.
RECEIPT OF NOTICE
On this day I read this form or had it read to me, and I received four copies of it. I understand that if I want to appeal the order denying
my petition for waiver of parental consent, I must complete and file the notice of appeal with the family division of this circuit court
within 24 hours of the date of the order.
Date
Time
Date
Time
Initials of minor/Signature of next friend
Name of next friend (type or print)
NOTICE OF APPEAL
TO THE CIRCUIT COURT: The minor appeals the order denying waiver of parental consent for an abortion and requests the court
to appoint an attorney to appeal the order.
See other side for Order for Court-Appointed Attorney and Claim of Appeal.
Initials of minor/Signature of next friend
Name of next friend (type or print)
Do not write below this line - For court use only
NOTICE OF APPEAL FILED ON:
Date
Time
I certify that the Notice of Appeal
filed within 24 hours of the date of the order denying the petition.
was not
was
Deputy clerk
PC 121 (9/10) APPEAL OF ORDER DENYING PETITION FOR WAIVER OF PARENTAL CONSENT
MCL 722.904, MCR 3.615
APPEAL OF ORDER DENYING PETITION
FOR WAIVER OF PARENTAL CONSENT
File No.
ORDER FOR COURT-APPOINTED ATTORNEY AND PREPARATION OF TRANSCRIPT
IT IS ORDERED:
1.
Address
City, state, zip
Name of attorney (type or print)
Bar no.
Telephone no.
is appointed attorney to represent the minor on her appeal of the order denying her petition for waiver of parental consent. The
appeal shall be perfected within 72 hours of the filing of the notice of appeal.
2. The court reporter/recorder shall immediately prepare the transcript of the proceedings and file two copies with the family division
of the circuit court within 72 hours from the date of this order.
3. Upon filing of the transcript, the court clerk shall notify the attorney that the transcript is available and shall immediately forward
the file, including one copy of the transcript, to the Court of Appeals.
Date
Judge
Bar no.
TO THE COURT OF APPEALS:
CLAIM OF APPEAL
In the matter of the petition of
, a minor, for waiver of parental consent for an abortion
Initials
1. The petitioner claims an appeal from the order denying waiver of parental consent for an abortion (copy attached) which was
in the
County Circuit Court, Michigan
entered on
Date
by Judge
2. The brief on appeal is attached.
Date
Attorney signature
.
Bar no.
Address
City, state, zip
Name of attorney (type or print)
Bar no.
Telephone no.
Appeal of Order Denying Petition for Waiver of Parental Consent
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:
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.
cirno was cirno (0.60 conf)county was county (0.39 conf)docket_number was caseno (1.00 conf)judge was judge (0.39 conf)pname was pname (0.35 conf)hdate was hdate (0.35 conf)htime was htime (0.35 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
Suggested Screen 1:
Suggested Screen 2:
Create an Interactive Version of this Form:
The Weaver creates a draft guided interview from a template form, like the one provided here.
To learn more, read "Weaving" your form into a draft interview.
