This form contains 39 fields organized into 16 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Case Matter Description
Case matter description	Text	Enter the name or brief description of the matter (for example, the person, trust, or estate) for which protected personal identifying information is being supplied.
Case Number and Judge
Case Number	Text	Enter the case number assigned by the court for this matter.
Judge Name	Text	Enter the full name of the judge presiding over this case.
Court Contact Information
Court Address	Text	Enter the full mailing address of the court, including street, city, state, and ZIP code.
Court Telephone Number	Text	Enter the court’s main telephone number, including area code.
Court Division Identifiers
Judicial District	Text	Enter the Michigan judicial district that has jurisdiction over this case.
Judicial Circuit	Text	Enter the Michigan judicial circuit that has jurisdiction over this case.
County Probate	Text	Enter the Michigan county probate division that has jurisdiction over this case.
Eighth PII Reference (Ref No. 17)
Name (Ref No. 17)	Text	Enter the full name of the person whose protected personal identifying information is assigned reference number 17.
Date of Birth (Ref No. 17)	Date	Enter the date of birth of the person whose protected personal identifying information is assigned reference number 17.
Other PII (Ref No. 17)	Text	Specify any additional personal identifying information for reference number 17, such as Social Security Number, including the type and value.
Fifth PII Reference (Ref No. 14)
Fifth PII Reference Name	Text	Enter the full name of the person associated with reference number 14.
Fifth PII Reference Date of Birth	Date	Enter the date of birth of the person associated with reference number 14.
Fifth PII Reference Other PII	Text	Provide any other required personal identifying information (for example, Social Security number) for reference number 14.
Filer Name and Date
Filer’s printed name and date	Text	Enter the printed name of the individual completing this form and the date it is completed.
First PII Reference (Ref No. 10)
First PII Reference Name	Text	Enter the full name of the person whose personal identifying information is listed under the first reference (Ref. No. 10).
First PII Reference Date of Birth	Date	Enter the date of birth for the person whose PII is listed under the first reference (Ref. No. 10), in MM/DD/YYYY format.
First PII Reference Other PII	Text	Enter any other required personal identifying information (specify the type, e.g., Social Security Number) for the person listed under the first reference (Ref. No. 10).
Fourth PII Reference (Ref No. 13)
Fourth PII Reference Name	Text	Enter the full name of the person whose protected personal identifying information is assigned reference number 13.
Fourth PII Reference Date of Birth	Date	Enter the date of birth of the person whose protected personal identifying information is assigned reference number 13.
Fourth PII Reference Other Information	Text	Enter any other protected personal identifying information (with type specified, such as Social Security Number) for the person assigned reference number 13.
Ninth PII Reference (Ref No. 18)
Name for Ninth PII Reference	Text	Provide the full name of the person associated with PII reference number 18.
Date of Birth for Ninth PII Reference	Date	Provide the date of birth of the person associated with PII reference number 18.
Other PII for Ninth PII Reference	Text	Provide any other required personal identifying information (for example, Social Security Number) for PII reference number 18.
Party Names
Plaintiff/Petitioner Name	Text	Enter the full name of the plaintiff or petitioner in this case.
Defendant/Respondent Name	Text	Enter the full name of the defendant or respondent in this case.
Related Public Document Name
Name of related public document	Text	Enter the name of the public form or document that this MC 97a addendum is being filed with.
Second PII Reference (Ref No. 11)
Second PII Reference Person Name	Text	Enter the full name of the person whose personal identifying information is being provided as reference number 11.
Second PII Reference Date of Birth	Date	Enter the date of birth (MM/DD/YYYY) for the person whose information is referenced as number 11.
Second PII Reference Other PII	Text	Specify the type and value of any additional personal identifying information (for example, Social Security Number) for the person listed under reference number 11.
Seventh PII Reference (Ref No. 16)
Seventh PII reference name	Text	Enter the full name of the individual to whom the seventh protected personal identifying information (Ref. No. 16) applies.
Seventh PII reference date of birth	Date	Enter the date of birth of the individual for the seventh protected personal identifying information (Ref. No. 16).
Seventh PII reference other information	Text	Provide the type and value of any other required protected personal identifying information for the seventh reference (Ref. No. 16), such as a Social Security number.
Sixth PII Reference (Ref No. 15)
Sixth PII Reference Name	Text	Enter the full name of the individual whose protected personal identifying information is assigned reference number 15.
Sixth PII Reference Date of Birth	Date	Enter the date of birth of the individual whose protected personal identifying information is assigned reference number 15.
Sixth PII Reference Other PII	Text	Specify any other required protected personal identifying information (for example, Social Security Number) for the individual assigned reference number 15.
Third PII Reference (Ref No. 12)
Ref. No. 12 Name	Text	Enter the full name of the person to whom reference number 12 applies.
Ref. No. 12 Date of Birth	Date	Enter the date of birth of the person to whom reference number 12 applies.
Ref. No. 12 Other PII	Text	Enter any other protected personal identifying information (with the type specified) for the person to whom reference number 12 applies.

Form MC 97a, Addendum to Protected Personal Identifying Information Instructions