Michigan > Statewide > Emancipation
Petition For Emancipation And Affidavit And Waiver Of Notice PC 100 - Michigan
| Petition For Emancipation And Affidavit And Waiver Of Notice Form. This is a Michigan form and can be used in Emancipation Statewide . |
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Approved, SCAO JIS CODE: PEM STATE OF MICHIGAN JUDICIAL CIRCUIT - FAMILY DIVISION FILE NO. PETITION FOR EMANCIPATION, AFFIDAVIT, AND WAIVER OF NOTICE , a minor and my social security COUNTY In the matter of the emancipation of 1. My full name is number is First name, middle name, and last name (type or print) Last 4 digits . 2. An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor has been previously filed in assigned to Judge 3. I am at least 16 years of age. I was born on County, State Date Court, Case Number , and remains in is no longer , was pending. . A certified copy of my birth certificate is attached to this petition. 4. The name(s) and last known address(es) of my parents, guardian, or custodian are: NAME RELATIONSHIP Father Mother Guardian Custodian 5. I presently reside within this county at City, state, zip ADDRESS Street address and I have lived there continuously since Date . 6. I am able to manage my own financial affairs as shown by the following facts: I am employed by: (PLEASE SEE OTHER SIDE) Do not write below this line - For court use only PC 100 (11/05) PETITION FOR EMANCIPATION, AFFIDAVIT, AND WAIVER OF NOTICE MCL 722.4 American LegalNet, Inc. www.FormsWorkflow.com 7. I am able to manage my personal and social affairs as shown by the following facts: My housing arrangements are: 8. I have read the Emancipation of Minors laws (Michigan Compiled Laws 722.1 through 722.6), and I understand my rights and responsibilities as an emancipated minor. I REQUEST the court to order my emancipation. I declare that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Minor's signature Attorney signature Name (type or print) Address Bar no. City State Zip Telephone no. AFFIDAVIT 1. I am a Address Occupation City Name (type or print) , and I conduct business at or am employed at State Zip Telephone no. . 2. I have personally known , a minor, for years, and I have personal knowledge of his/her current circumstances. 3. I believe that emancipation would be in the best interests of the minor because of the following circumstances: 4. I have reviewed this petition, and I waive notice of hearing and any adjournment of the hearing. Date Signature of affiant Name (type or print) Address City, state zip Telephone no. Subscribed and sworn to before me on My commission expires: Date Date , Signature: Notary public County, Michigan. Notary public, State of Michigan, County of American LegalNet, Inc. www.FormsWorkflow.com
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