Form JC 60 Notice of Intent to Intercept State Income Tax - Michigan

Form JC60 is a Michigan Juvenile Court form also known as the "Notice Of Intent To Intercept State Income Tax". The latest edition of the form was released in June 1, 2003 and is available for digital filing.

Download a PDF version of the Form JC60 down below or find it on Michigan Juvenile Court Forms website.

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Original - Payer
Approved, SCAO
Copy - Court
CASE NO.
STATE OF MICHIGAN
PETITION NO.
NOTICE OF INTENT TO INTERCEPT
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
STATE INCOME TAX
Court address
Telephone no.
1.
In the matter of
(name(s), alias(es), DOB)
Date of notice
TO:
Social security number
Amount delinquent
1. Any Michigan tax refund due to you may be intercepted for the amount shown above. Your name is being referred to the
Michigan Department of Treasury for collection of past due reimbursement for the cost of care and/or service.
2. You have the right to an informal hearing if you believe the amount claimed above is in error. To request an informal hearing,
you must contact the circuit court at the address shown above within 7 days of the date of this notice or another date
specified by the court.
3. Notice to intercept a joint refund will be sent to you automatically by the Michigan Department of Treasury at the time your return
is processed.
Do not write below this line - For court use only
NOTICE OF INTENT TO INTERCEPT STATE INCOME TAX
JC 60 (6/03)
MCL 712A.18(2), MCL 769.1(7)
Original - Payer
Approved, SCAO
Copy - Court
CASE NO.
STATE OF MICHIGAN
PETITION NO.
NOTICE OF INTENT TO INTERCEPT
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
STATE INCOME TAX
Court address
Telephone no.
1.
In the matter of
(name(s), alias(es), DOB)
Date of notice
TO:
Social security number
Amount delinquent
1. Any Michigan tax refund due to you may be intercepted for the amount shown above. Your name is being referred to the
Michigan Department of Treasury for collection of past due reimbursement for the cost of care and/or service.
2. You have the right to an informal hearing if you believe the amount claimed above is in error. To request an informal hearing,
you must contact the circuit court at the address shown above within 7 days of the date of this notice or another date
specified by the court.
3. Notice to intercept a joint refund will be sent to you automatically by the Michigan Department of Treasury at the time your return
is processed.
Do not write below this line - For court use only
NOTICE OF INTENT TO INTERCEPT STATE INCOME TAX
JC 60 (6/03)
MCL 712A.18(2), MCL 769.1(7)

Download Form JC 60 Notice of Intent to Intercept State Income Tax - Michigan

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