STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT PROOF OF ...

JIS CODE:POM

STATE OF MICHIGAN

JUDICIAL DISTRICT

JUDICIAL CIRCUIT

COUNTY

CASE NO. and JUDGE

PROOF OF MAILING

Court address

Court telephone no.

Plaintiff¡¯s name, address, and telephone no.

Defendant¡¯s name, address, and telephone no.

v

Plaintiff¡¯s attorney, bar no., address, and telephone no.

Defendant¡¯s attorney, bar no., address, and telephone no.

In the matter of

On the date below I sent by first-class mail a copy of

to: List names and addresses.

I declare under the penalties of perjury that this proof of mailing has been examined by me and that its contents are true to

the best of my information, knowledge, and belief.

Date

Approved, SCAO

Form MC 302, Rev. 3/21

MCR 2.107(C)(3),(D)

Page 1 of 1

Signature

Name (type or print)

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