Form Foc 10a / 52a - Uniform Child Support Order - Michigan Judicial Circuit County Page 3

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Original - Court
2nd copy - Defendant
1st copy - Plaintiff
Approved, SCAO
3rd copy - Friend of the court
STATE OF MICHIGAN
CASE NO.
UNIFORM CHILD SUPPORT ORDER,
JUDICIAL CIRCUIT
NO FRIEND OF COURT SERVICES (PAGE 3)
COUNTY
EX PARTE
TEMPORARY
MODIFICATION
FINAL
Court address
Court telephone no.
Plaintiff's name
Defendant's name
v
9. Other: (Attach separate sheets as needed.)
Plaintiff (if consent/stipulation)
Date
Date
Defendant (if consent/stipulation)
Plaintiff's attorney
Date
Defendant's attorney
Date
Prepared by:
Name (type or print)
Bar no.
Date
Judge
CERTIFICATE OF MAILING
I certify that on this date 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 in MCR 3.203.
I certify that I also served the Deviation Addendum (FOC 10d) with the order.
Date
Signature
COURT USE ONLY
MCL 552.14, MCL 552.517, MCL 552.517b(3),
UNIFORM CHILD SUPPORT ORDER, NO FRIEND OF COURT SERVICES, PAGE 3
FOC 10a / 52a (11/16)
MCR 3.211

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