Form Mc 82 (4/14) - Payment Receipt And Inventory Of Seized Property Form
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1Original - Court
2nd copy - Officer
Approved, SCAO
1st copy - Defendant
3rd copy - Plaintiff
STATE OF MICHIGAN
CASE NO.
JUDICIAL DISTRICT
PAYMENT RECEIPT AND
JUDICIAL CIRCUIT
INVENTORY OF SEIZED PROPERTY
Court address
Court telephone no.
Plaintiff's name(s)
Defendant's name(s)
v
TO THE OFFICER SEIZING PROPERTY: This form must be filed with the court within 7 days of the payment of funds or seizure
of property.
RECEIPT FOR PAYMENT OF FUNDS
1. I collected $
on
from
.
Date
2. Payment was made by
cash.
check no.
.
money order/cashier's check no.
.
3. a. Balance due .......................................................................................................
$
b. Minus payment ...................................................................................................
$
c. Statutory service and mileage fees ....................................................................................................
$
d. Statutory percentage of line b fees : 7% of
/ 3% of
.
........................................
$
e. Statutory expenses ............................................................................................................................
$
0.00
f. Plus total of lines c, d, and e above ....................................................................
$
g. New balance due* ............................................................................................
$
0
*Additional statutory interest, fees (7% of first $8,000.00 and 3% of remaining balance), and expenses may be charged in addition to the
unpaid balance.
INVENTORY OF PROPERTY SEIZED
Attach additional sheets if necessary.
Quantity
Item/Description/Model
Type/V.I.N./Serial Number
Real property seized (copy attached)
.
Property may be redeemed by payment in full of the judgment and all statutory fees and statutory expenses. If the property is not
redeemed, it will be sold at public sale and the proceeds applied to the judgment according to law. For further information call the
individual named below.
I certify that I am authorized to seize property under MCR 3.106 and that the above statements are true and accurate.
Date
Signature
Name (type or print) (Court officer/Deputy sheriff)
Telephone no.
PAYMENT RECEIPT AND INVENTORY OF SEIZED PROPERTY
MCR 3.106
MC 82 (4/14)
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