Form Jc01 "Complaint (Request for Action, Delinquency Proceedings)" - Michigan

Form JC01 is a Michigan Juvenile Court form also known as the "Complaint (request For Action, Delinquency Proceedings)". The latest edition of the form was released in December 1, 2018 and is available for digital filing.

Download an up-to-date Form JC01 in PDF-format down below or look it up on the Michigan Juvenile Court Forms website.

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Approved, SCAO
JIS CODE: CMP
STATE OF MICHIGAN
CASE NO.
PETITION NO.
JUDICIAL CIRCUIT - FAMILY DIVISION
COMPLAINT (REQUEST FOR ACTION,
COUNTY
DELINQUENCY PROCEEDINGS)
Court address
Court telephone no.
1. In the matter of
name(s), alias(es), DOB
2. Date of birth
3. Sex
4. Race
5. Member of or eligible for membership in Indian Tribe
6. Height
7. Weight
8. Eye color
9. Hair color
10. School/District
11. Municipality and county of legal residence
BASIS FOR REQUEST
12. Brief statement of the allegations and basis for any request for court-ordered apprehension, including the citations and
date, time, and location of offense
Operator/Chauffeur driver license
Commercial driver license
No license
Vehicle type
13. Codefendant(s): name(s), alias(es), DOB
SOCIAL INFORMATION
14. Parent’s name
Address
Home phone
Work phone
15. Parent’s name
Address
Home phone
Work phone
16. Stepparent’s name
Address
Home phone
Work phone
17. Guardian/Legal custodian’s name
Address
Home phone
Work phone
18. Divorced?
Date of divorce
Place of divorce:
No
Yes
(county, state)
19. Custody to: (Specify name and include address if not previously listed)
20. Juvenile living with: (Specify name and relationship)
REQUEST
21. I REQUEST
a. a petition be authorized.
b. the court review the information and make an appropriate disposition.
c. an order be issued to apprehend the juvenile pending the preliminary hearing pursuant to MCR 3.933(B).
permission to enter the premises at
.
d. an order be issued to detain the juvenile pending the preliminary hearing pursuant to MCR 3.934(B).
I declare that this complaint has been examined by me and that its contents are true to the best of my information, knowledge,
and belief.
Complainant’s signature
Date
Print or type name
Address/Agency
Telephone no.
MCL 712A.2, MCL 712A.11, MCL 712A.14, MCL 712A.15, MCR 3.903(A)(9), MCR 3.933(A), MCR 3.934, MCR 3.983
COMPLAINT (REQUEST FOR ACTION, DELINQUENCY PROCEEDINGS)
JC 01 (12/18)
Approved, SCAO
JIS CODE: CMP
STATE OF MICHIGAN
CASE NO.
PETITION NO.
JUDICIAL CIRCUIT - FAMILY DIVISION
COMPLAINT (REQUEST FOR ACTION,
COUNTY
DELINQUENCY PROCEEDINGS)
Court address
Court telephone no.
1. In the matter of
name(s), alias(es), DOB
2. Date of birth
3. Sex
4. Race
5. Member of or eligible for membership in Indian Tribe
6. Height
7. Weight
8. Eye color
9. Hair color
10. School/District
11. Municipality and county of legal residence
BASIS FOR REQUEST
12. Brief statement of the allegations and basis for any request for court-ordered apprehension, including the citations and
date, time, and location of offense
Operator/Chauffeur driver license
Commercial driver license
No license
Vehicle type
13. Codefendant(s): name(s), alias(es), DOB
SOCIAL INFORMATION
14. Parent’s name
Address
Home phone
Work phone
15. Parent’s name
Address
Home phone
Work phone
16. Stepparent’s name
Address
Home phone
Work phone
17. Guardian/Legal custodian’s name
Address
Home phone
Work phone
18. Divorced?
Date of divorce
Place of divorce:
No
Yes
(county, state)
19. Custody to: (Specify name and include address if not previously listed)
20. Juvenile living with: (Specify name and relationship)
REQUEST
21. I REQUEST
a. a petition be authorized.
b. the court review the information and make an appropriate disposition.
c. an order be issued to apprehend the juvenile pending the preliminary hearing pursuant to MCR 3.933(B).
permission to enter the premises at
.
d. an order be issued to detain the juvenile pending the preliminary hearing pursuant to MCR 3.934(B).
I declare that this complaint has been examined by me and that its contents are true to the best of my information, knowledge,
and belief.
Complainant’s signature
Date
Print or type name
Address/Agency
Telephone no.
MCL 712A.2, MCL 712A.11, MCL 712A.14, MCL 712A.15, MCR 3.903(A)(9), MCR 3.933(A), MCR 3.934, MCR 3.983
COMPLAINT (REQUEST FOR ACTION, DELINQUENCY PROCEEDINGS)
JC 01 (12/18)
Complaint (Request for Action, Delinquency Proceedings) (12/18) Page
of
Case No.
Petition No.
CUSTODY
Fill out completely
22. Basis for apprehension by police without court order
23. Check if applicable
The officer had reason to believe that because of the nature of the offense, the interest
Miranda warning given
Attorney present
of the juvenile or the interest of the public would not be protected by release of the
Offense admitted
Biometric data collected
juvenile.
Offense denied
Photograph taken
Parent/guardian/legal custodian could not be located or refused to take custody of the
Parents/Guardian/Legal
Line-up held
juvenile.
custodian present
24. Release and recognizance
I acknowledge that the juvenile has been released to my custody, and I promise to bring the juvenile to the court upon notice.
Date
Signature
Relationship to juvenile
NOTIFICATION TO PARENT, GUARDIAN, OR LEGAL CUSTODIAN
25. I notified or attempted to notify the person(s) listed below about the date, time, and place of the preliminary hearing. The method of contact or attempted
contact is described below and includes the date and time of notification for each.
26. Name
Methods used
Date
Time
notified
attempted
27. Name
Methods used
Date
Time
notified
attempted
28. Name
Methods used
Date
Time
notified
attempted
29. Name
Methods used
Date
Time
notified
attempted
ADDITIONAL COMMENTS
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