1. This order is entered 

 

 after hearing. 

 

 on consent/stipulation of the parties.

THE COURT FINDS:

 2. A motion requesting parenting time/change of parenting time was filed.

 3. A response to the motion was filed.

 4. It 

 

 is 

 is not 

 

in the best interests of the child(ren) to 

 

 establish 

 change 

  parenting time.

 5. It is in the best interests of the child(ren) to dismiss the motion.

IT IS ORDERED:

 6. The motion is dismissed. Parenting time is unchanged and the existing order remains in effect.

 established 
 7. Parenting time is 
    Explain in detail what the court has ordered.

 

 

 

 changed 

 

 to be made up 

  as follows:

D E F G H I J

Plaintiff’s name, address, and telephone no.

Defendant’s name, address, and telephone no.

Third party’s name, address, and telephone no.

v

 

 

  Date: 
 

 

 

  Judge: 

 

8. Except as changed in this order, the prior order (if there is one) remains in effect.

9. Except as provided in item 10, neither parent shall exercise parenting time in a foreign country/nation that is not a 
  party to the Hague Convention on the Civil Aspects of International Child Abduction.

Approved, SCAO
Form FOC 67, Rev. 3/21
MCL 552.14, MCL 722.27a, MCR 2.119
Page 1 of 2

Distribute form to: 
Court 
Other party 
Moving party 
Friend of the court
Proof of service

STATE OF MICHIGANJUDICIAL COURTCOUNTYORDER REGARDING PARENTING TIMECASE NO. and JUDGECourt address                 Court telephone no.BACOrder Regarding Parenting Time 
Page 2 of 2

(3/21) 

Case No. 
 

 10.  Based on written agreement of the parties, 

Name

 
 
 

      exercise parenting time in 
   
      on the Civil Aspects of International Child Abduction. 

Name of foreign country/nation

 , which is not a party to the Hague Convention

 may 

K

 

Plaintiff’s signature (consent/stipulation)

Defendant’s signature (consent/stipulation)

Third party’s signature (consent/stipulation)

L

Approved as to form: 

Friend of the court signature (only if required)

 
 

                                                                                      Judge signature and date
 

CERTIFICATE OF MAILING

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

I served a copy of this order on the parties or their attorneys by first-class mail addressed to their last-known addresses 
as defined by MCR 3.203. I declare under the penalties of perjury that this certificate of mailing has been examined by 
me and that its contents are true to the best of my information, knowledge, and belief.

M

Date

                                                  

Signature