This form contains 76 fields organized into 23 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Adjournment From Date
The above matter is adjourned from Checkbox
Check this box if the court matter has been adjourned (rescheduled) from a previously scheduled date and you will provide the prior date.
Adjourned From Date Date
Enter the original date the matter was scheduled for before it was adjourned.
Case Number, Judge, and Offense
Case no Text
Offense Text
Enter the offense or charge associated with this notice to appear.
Judge Text
Enter the name of the judge assigned to this case.
Case Number Text
Enter the court case number assigned to this matter.
Court Address and Telephone
Court Address Text
Enter the full mailing address of the court (street address, city, state, and ZIP code).
Court Telephone Number Text
Enter the court's telephone number.
Court Jurisdiction (District/Circuit/County)
Judicial District Text
Enter the judicial district number or name for the court issuing this notice.
Judicial Circuit Text
Enter the judicial circuit number or name for the court issuing this notice.
County Text
Enter the Michigan county in which this court is located.
Defendant and Service Method
Defendant name and address Text
Enter the defendant’s full name and mailing address as it should appear on the notice.
Personal service (Defendant) Checkbox
Check this box if the defendant was served by personal service.
Defendant's Attorney and Service Method
Defendant's Attorney Name and Address Text
Enter the defendant’s attorney’s full name and mailing address for service of this notice.
Personal service (Defendant’s attorney) Checkbox
Check this box if the notice will be personally served on the defendant’s attorney.
Directed Appearance Location and Judge
The court address above (courtroom) Checkbox
Check this box if the person is directed to appear at the court address listed above, in the specified courtroom.
Courtroom Text
Enter the courtroom number or designation where the person is directed to appear at the court address listed above. Fill only if 'The court address above (courtroom)' is 'Yes'.
Depends on: The court address above (courtroom)
Other appearance location Checkbox
Check this box if the person is directed to appear at a different address/location than the court address above (enter the location on the lines provided).
Alternate Appearance Location (Line 1) Text
Enter the first line of the alternate location where the person is directed to appear (if not appearing at the court address above). Fill only if 'Other appearance location' is 'Yes'.
Depends on: Other appearance location
Alternate Appearance Location (Line 2) Text
Enter the second line of the alternate appearance location, such as additional address details, building, or room information. Fill only if 'Other appearance location' is 'Yes'.
Depends on: Other appearance location
Judge Name Text
Enter the name of the judge assigned for the directed appearance.
Eighth Purpose Row (Motion)
Motion Checkbox
Check this box if the required court appearance is for a motion hearing.
Motion Location (Courtroom/Place) Text
Enter the courtroom number or other location where the motion will be heard. Fill only if 'Motion' is 'Yes'.
Depends on: Motion
Motion Date Date
Enter the date scheduled for the motion hearing. Fill only if 'Motion' is 'Yes'.
Depends on: Motion
Motion Time Time
Enter the time scheduled for the motion hearing. Fill only if 'Motion' is 'Yes'.
Depends on: Motion
Eleventh Purpose Row (Formal Hearing)
Formal Hearing Checkbox
Check this box when the person is being ordered to appear for a formal hearing.
Formal Hearing Courtroom or Location Text
Enter the courtroom number or specific place where the formal hearing will be held. Fill only if 'Formal Hearing' is 'Yes'.
Depends on: Formal Hearing
Formal Hearing Date Date
Enter the date on which the formal hearing is scheduled. Fill only if 'Formal Hearing' is 'Yes'.
Depends on: Formal Hearing
Formal Hearing Time Time
Enter the time at which the formal hearing is scheduled to begin. Fill only if 'Formal Hearing' is 'Yes'.
Depends on: Formal Hearing
Fifth Purpose Row (Jury Trial)
Jury Trial Checkbox
Check this box if the appearance is scheduled for a jury trial.
Jury Trial Courtroom or Place Text
Enter the courtroom number or other location where the jury trial will be held. Fill only if 'Jury Trial' is 'Yes'.
Depends on: Jury Trial
Jury Trial Date Date
Enter the scheduled date of the jury trial. Fill only if 'Jury Trial' is 'Yes'.
Depends on: Jury Trial
Jury Trial Time Time
Enter the scheduled time for the jury trial to begin. Fill only if 'Jury Trial' is 'Yes'.
Depends on: Jury Trial
First Purpose Row (Probable Cause Conference)
Probable Cause Conference Checkbox
Check this box if the appearance is being ordered for a Probable Cause Conference.
Probable Cause Conference Location Text
Enter the courtroom number or other place where the probable cause conference will be held. Fill only if 'Probable Cause Conference' is 'Yes'.
Depends on: Probable Cause Conference
Probable Cause Conference Date Date
Enter the date the probable cause conference is scheduled to occur. Fill only if 'Probable Cause Conference' is 'Yes'.
Depends on: Probable Cause Conference
Probable Cause Conference Time Time
Enter the time the probable cause conference is scheduled to begin. Fill only if 'Probable Cause Conference' is 'Yes'.
Depends on: Probable Cause Conference
Fourth Purpose Row (Jury Selection)
Jury Selection Checkbox
Check this box if the notice is directing the recipient to appear for jury selection.
Jury Selection Courtroom or Place Text
Enter the courtroom number or location where the jury selection will be held. Fill only if 'Jury Selection' is 'Yes'.
Depends on: Jury Selection
Jury Selection Date Date
Enter the date on which the jury selection is scheduled. Fill only if 'Jury Selection' is 'Yes'.
Depends on: Jury Selection
Jury Selection Time Time
Enter the time at which the jury selection is scheduled to begin. Fill only if 'Jury Selection' is 'Yes'.
Depends on: Jury Selection
Ninth Purpose Row (Arraignment)
Arraignment Checkbox
Check this box when the notice to appear is for an arraignment hearing.
Arraignment Courtroom or Place Text
Enter the courtroom, room number, or location where the arraignment will be held. Fill only if 'Arraignment' is 'Yes'.
Depends on: Arraignment
Arraignment Date Date
Enter the date on which the arraignment is scheduled. Fill only if 'Arraignment' is 'Yes'.
Depends on: Arraignment
Arraignment Time Time
Enter the time at which the arraignment is scheduled to begin. Fill only if 'Arraignment' is 'Yes'.
Depends on: Arraignment
Officer
Officer Name Text
Enter the name of the officer issuing or serving this Notice to Appear.
Page 2
Date Issued Date
Enter the date this notice was issued.
Plaintiff and Service Method
Court Address Text
Enter the full mailing address of the court issuing the notice.
Personal service Checkbox
Check this box if the notice/summons will be served on the party by personal (in-person) service.
Plaintiff's Attorney/People and Service Method
Plaintiff's Attorney/People Information Text
Enter the name and contact information (such as firm/agency, address, and phone number) for the plaintiff’s attorney or the people representing the plaintiff.
Personal service (Plaintiff’s attorney/People) Checkbox
Check this box if the notice will be served on the plaintiff’s attorney/people by personal (in-person) service.
Second Purpose Row (Preliminary Exam)
Preliminary Exam Checkbox
Check this box when the notice is being issued for a preliminary examination hearing.
Preliminary Exam Courtroom or Place Text
Enter the courtroom number or the location where the preliminary exam will be held. Fill only if 'Preliminary Exam' is 'Yes'.
Depends on: Preliminary Exam
Preliminary Exam Date Date
Enter the date scheduled for the preliminary exam. Fill only if 'Preliminary Exam' is 'Yes'.
Depends on: Preliminary Exam
Preliminary Exam Time Time
Enter the time scheduled for the preliminary exam. Fill only if 'Preliminary Exam' is 'Yes'.
Depends on: Preliminary Exam
Seventh Purpose Row (Sentencing)
Sentencing Checkbox
Check this box if the person is being ordered to appear for a sentencing hearing.
Sentencing Courtroom or Place Text
Enter the courtroom number or location where the sentencing will be held. Fill only if 'Sentencing' is 'Yes'.
Depends on: Sentencing
Sentencing Date Date
Enter the date scheduled for the sentencing hearing. Fill only if 'Sentencing' is 'Yes'.
Depends on: Sentencing
Sentencing Time Time
Enter the time scheduled for the sentencing hearing. Fill only if 'Sentencing' is 'Yes'.
Depends on: Sentencing
Sixth Purpose Row (Nonjury Trial)
Nonjury Trial Checkbox
Check this box if the person is being ordered to appear for a nonjury (bench) trial.
Nonjury Trial Location Text
Enter the courtroom, room number, or other place where the nonjury trial will be held. Fill only if 'Nonjury Trial' is 'Yes'.
Depends on: Nonjury Trial
Nonjury Trial Date Date
Enter the date the nonjury trial is scheduled to take place. Fill only if 'Nonjury Trial' is 'Yes'.
Depends on: Nonjury Trial
Nonjury Trial Time Time
Enter the time the nonjury trial is scheduled to begin. Fill only if 'Nonjury Trial' is 'Yes'.
Depends on: Nonjury Trial
Tenth Purpose Row (Informal Hearing)
Informal Hearing Checkbox
Check this box when the purpose of the scheduled court appearance is an informal hearing.
Informal Hearing Location Text
Enter the courtroom, room number, or other place where the informal hearing will be held. Fill only if 'Informal Hearing' is 'Yes'.
Depends on: Informal Hearing
Informal Hearing Date Date
Enter the date of the informal hearing. Fill only if 'Informal Hearing' is 'Yes'.
Depends on: Informal Hearing
Informal Hearing Time Time
Enter the time the informal hearing is scheduled to begin. Fill only if 'Informal Hearing' is 'Yes'.
Depends on: Informal Hearing
Third Purpose Row (Pretrial Conference)
Pretrial Conference Checkbox
Check this box if the notice is directing the recipient to appear for a pretrial conference.
Pretrial conference location Text
Enter the courtroom number or place where the pretrial conference will be held. Fill only if 'Pretrial Conference' is 'Yes'.
Depends on: Pretrial Conference
Pretrial conference date Date
Enter the date of the pretrial conference. Fill only if 'Pretrial Conference' is 'Yes'.
Depends on: Pretrial Conference
Pretrial conference time Time
Enter the time the pretrial conference is scheduled to begin. Fill only if 'Pretrial Conference' is 'Yes'.
Depends on: Pretrial Conference
Twelfth Purpose Row (Other Purpose)
Other purpose (specify) Checkbox
Check this box if the appearance is for a purpose not listed above, and write the specific purpose on the provided line.
Other purpose Text
Enter the description of the other court appearance purpose not listed above.
Courtroom or place (Other purpose) Text
Enter the courtroom number or location where the appearance for the other purpose will be held. Fill only if 'Other purpose (specify)' is 'Yes'.
Depends on: Other purpose (specify)
Date (Other purpose) Date
Enter the scheduled date for the appearance for the other purpose. Fill only if 'Other purpose (specify)' is 'Yes'.
Depends on: Other purpose (specify)
Time (Other purpose) Time
Enter the scheduled time for the appearance for the other purpose. Fill only if 'Other purpose (specify)' is 'Yes'.
Depends on: Other purpose (specify)