The Circuit Court For The Third Judicial Circuit Of Michigan

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The Circuit Court
For the Third Judicial Circuit of Michigan
OFFICE OF THE FRIEND OF THE COURT
Information Services Department
PENOBSCOT BUILDING
645 GRISWOLD
DETROIT, MICHIGAN 48226
(Please Fill-In)
Payor Name: __________________________________________________
Friend of the Court Case Number: ________________________________
Payor Social Security Number:
________________________________
Dear Friend of the Court Payor:
This form is in response to your inquiry about your joint tax refund.
It will take
approximately ninety (90) days from the date you receive your letter notifying you that your
tax refund was intercepted for your Federal Tax Refund to reach Wayne County Friend of
the Court.
If an Injured Spouse Claim Form has been filed, the IRS requires that the Court hold the
funds for a minimum of six (6) months. This allows the IRS to adjust the amount of
money the Court may credit the account. The IRS, not the Friend of the Court, will
determine your current spouse’s portion of the income tax refund and return it directly to
them.
If your spouse has not filed and will not file an Injured Spouse Claim Form, your spouse
should fill out #1. If your spouse has filed an Injured Spouse Claim form, your spouse
should fill out #2. Please have this form notarized, make a copy for your records, and
nd
return original to: TIP FOC 645 GRISWOLD, 2
FLOOR, DETROIT MI 48226.
1) I, ___________________________________________ have not and will not file an
Injured Spouse Claim form. Please apply the tax refund to any arrears the account may
have and return the remainder to us.
2) I, ___________________________________________ have filed an Injured Spouse
Claim Form for my share of the income tax refund.
I understand that by signing this form I also authorize the Wayne County Friend of the
Court to recoup any negative adjustments that may occur on this case as a result of my filing
an Injured Spouse Claim Form after signing this letter.
Signature of Spouse: ______________________________________
Date: ______________________________________
Notary Public
TID (02/05) Injured Spouse

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