Form CC 404 Notice to Prisoner on Application for Leave to Appeal Decision of Parole Board - Michigan

Form CC404 or the "Notice To Prisoner On Application For Leave To Appeal Decision Of Parole Board" is a form issued by the Michigan Circuit Court.

Download a PDF version of the Form CC404 down below or find it on the Michigan Circuit Court Forms website.

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Original - Prisoner
3rd copy - Prison/Facility
1st copy - Parole board
4th copy - Court (for proof from prison/facility)
Approved, SCAO
2nd copy - Prosecutor/Victim
5th copy - Court (for proof from prosecutor/victim)
STATE OF MICHIGAN
CIRCUIT CASE NO:
NOTICE TO PRISONER ON
JUDICIAL CIRCUIT
APPEAL CASE NO:
APPLICATION FOR LEAVE TO APPEAL
COUNTY
JUDGE:
DECISION OF PAROLE BOARD
Court address
Court telephone no.
Prisoner’s name, address, and inmate no. (if known) Appellee
Appellant
THE PEOPLE OF THE STATE OF MicHigAn
v
NOTE: This form is required under McR 7.118(D)(3)(b).
TO THE PRISONER:
1. An application for leave to appeal a decision to grant parole is being filed with the circuit court.
(copy attached.)
2. You are not required to respond to the attached application. if you wish to respond to the application for leave to appeal, you
may respond yourself or hire an attorney to respond for you.
3. if an order of parole is issued under McL 791.236 before the appellate proceedings are completed, a stay may be
granted in the manner provided by McR 7.118(F), except that no bond is required.
TO THE PRISON/FACILITY: You are required to personally serve this notice, the application for leave to appeal, and any
supporting documents on the prisoner named above. After service on the prisoner, you must complete the proof of service on
the prisoner and file it with the clerk of the court.
PROOF OF SERVICE
i certify that on this date i served copies of this notice, the application for leave to appeal and any supporting documents by
registered or certified mail, return receipt requested on the parole board, the prosecutor (if filed by victim), the victim (when
appropriate), and on the facility where the prisoner is incarcerated.
Date
Signature of applicant/attorney
Note: Attach copies of the return receipts from the parole board and the prosecutor (when filed by the victim) and from the
victim (when appropriate), and file a copy of this proof of service with the clerk of the court.
PROOF OF SERVICE ON PRISONER
i certify that on this date i personally served this notice, the application for leave to appeal, and any supporting documents on
the prisoner named above.
Date
Signature of prison official
MCL 791.234(9), MCR 7.118(D)(3)
NOTICE TO PRISONER ON APPLICATION FOR LEAVE TO APPEAL DECISION OF PAROLE BOARD
CC 404 (7/16)
Original - Prisoner
3rd copy - Prison/Facility
1st copy - Parole board
4th copy - Court (for proof from prison/facility)
Approved, SCAO
2nd copy - Prosecutor/Victim
5th copy - Court (for proof from prosecutor/victim)
STATE OF MICHIGAN
CIRCUIT CASE NO:
NOTICE TO PRISONER ON
JUDICIAL CIRCUIT
APPEAL CASE NO:
APPLICATION FOR LEAVE TO APPEAL
COUNTY
JUDGE:
DECISION OF PAROLE BOARD
Court address
Court telephone no.
Prisoner’s name, address, and inmate no. (if known) Appellee
Appellant
THE PEOPLE OF THE STATE OF MicHigAn
v
NOTE: This form is required under McR 7.118(D)(3)(b).
TO THE PRISONER:
1. An application for leave to appeal a decision to grant parole is being filed with the circuit court.
(copy attached.)
2. You are not required to respond to the attached application. if you wish to respond to the application for leave to appeal, you
may respond yourself or hire an attorney to respond for you.
3. if an order of parole is issued under McL 791.236 before the appellate proceedings are completed, a stay may be
granted in the manner provided by McR 7.118(F), except that no bond is required.
TO THE PRISON/FACILITY: You are required to personally serve this notice, the application for leave to appeal, and any
supporting documents on the prisoner named above. After service on the prisoner, you must complete the proof of service on
the prisoner and file it with the clerk of the court.
PROOF OF SERVICE
i certify that on this date i served copies of this notice, the application for leave to appeal and any supporting documents by
registered or certified mail, return receipt requested on the parole board, the prosecutor (if filed by victim), the victim (when
appropriate), and on the facility where the prisoner is incarcerated.
Date
Signature of applicant/attorney
Note: Attach copies of the return receipts from the parole board and the prosecutor (when filed by the victim) and from the
victim (when appropriate), and file a copy of this proof of service with the clerk of the court.
PROOF OF SERVICE ON PRISONER
i certify that on this date i personally served this notice, the application for leave to appeal, and any supporting documents on
the prisoner named above.
Date
Signature of prison official
MCL 791.234(9), MCR 7.118(D)(3)
NOTICE TO PRISONER ON APPLICATION FOR LEAVE TO APPEAL DECISION OF PAROLE BOARD
CC 404 (7/16)

Download Form CC 404 Notice to Prisoner on Application for Leave to Appeal Decision of Parole Board - Michigan

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