This form contains 24 fields organized into 10 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Case Number and Judge
Text
Judge Text
Enter the name of the judge assigned to the case.
Case Number Text
Enter the court case number assigned to this matter.
Court Contact Information
Court address Text
Enter the full mailing address of the court (street, city, state, and ZIP code).
Court telephone number Text
Enter the court’s telephone number.
Court Identification
Judicial District Text
Enter the Michigan judicial district for the court handling this case.
Judicial Circuit Text
Enter the Michigan judicial circuit for the court handling this case.
County Text
Enter the Michigan county where the court is located.
Defendant/Respondent Information
Defendant/Respondent Name(s) and Address(es) Text
Enter the full name(s) and complete mailing address(es) of the defendant(s)/respondent(s).
Defendant/Respondent Attorney Information Text
Enter the defendant’s/respondent’s attorney name, bar number, address, and telephone number.
Dismissed Without Prejudice - Applies To
All parties Checkbox
Check this box if the case is dismissed without prejudice as to all parties.
Following defendant(s)/respondent(s) Checkbox
Check this box if the case is dismissed without prejudice only as to the defendant(s)/respondent(s) listed on the line that follows.
Defendants/Respondents Dismissed Without Prejudice Text
Enter the name(s) of the specific defendant(s) or respondent(s) to whom the dismissal without prejudice applies. Fill only if 'Following defendant(s)/respondent(s)' is 'Yes'.
Depends on: Following defendant(s)/respondent(s)
In the Matter Of
In the Matter Of Text
Enter the subject or case caption for the matter (e.g., the name of the person, estate, or proceeding) as it should appear on the court order.
Judge/Clerk Signature and Date
Text
Judge/Clerk Signature and Date Date
Enter the judge’s or authorized court clerk/register’s signature information and the date the order is signed.
No Progress/Notification Details
No Progress Since Date Date
Enter the date since which there has been no progress in the case. Fill only if 'No progress since a specified date; parties notified to appear and did not appear' is 'Yes'.
Depends on: No progress since a specified date; parties notified to appear and did not appear
Method of Notification Text
Enter how the parties were notified (for example, by mail, personal service, email, or other method). Fill only if 'No progress since a specified date; parties notified to appear and did not appear' is 'Yes'.
Depends on: No progress since a specified date; parties notified to appear and did not appear
Hearing Date and Time Text
Enter the date and time the parties were notified to appear. Fill only if 'No progress since a specified date; parties notified to appear and did not appear' is 'Yes'.
Depends on: No progress since a specified date; parties notified to appear and did not appear
Order to Dismiss - Grounds
Defendant(s)/respondent(s) not timely served with process Checkbox
Check this box if the court records show the defendant(s)/respondent(s) were not timely served with process as required by court rule.
No progress as specified in notice of intent to dismiss Checkbox
Check this box if the required case progress described in the notice of intent to dismiss has not occurred.
No progress since a specified date; parties notified to appear and did not appear Checkbox
Check this box if there has been no progress in the case since the stated date and the parties were notified to appear on the stated date/time but did not appear.
Plaintiff/Petitioner Information
Plaintiff/Petitioner Names and Addresses Text
Enter the full name(s) and mailing address(es) of the plaintiff(s)/petitioner(s).
Plaintiff/Petitioner Attorney Information Text
Enter the plaintiff/petitioner attorney’s name, bar number, address, and telephone number.