Claim Of Interest On Vehicle Seized For Forfeiture {MC 67}

Original - Court 2nd copy - Defendant Approved, SCAO 1st copy - Claimant 3rd copy - Prosecuting official STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT CLAIM OF INTEREST ON JUDICIAL CIRCUIT VEHICLE SEIZED FOR FORFEITURE COUNTY ORI Court address Court telephone no.MI- The State of Michigan Defendants name, address, and telephone no. THE PEOPLE OF v CTN SID DOB own 1. I lease the following vehicle which was seized for forfeiture as a sanction against defendant. hold security interest in Vehicle description: Year Make Model License plate no. Vehicle identification no. title for the vehicle 2. Attached is a copy of my lease for the vehicle. proof of security interest in the vehicle. 3. My interest in the vehicle is as follows: 4. I request a hearing to determine the legitimacy of my claim, my equity interest in the vehicle, and the defendants liability to me.Date Signature Name (type or print) Address City, state, zip Telephone no.MC 67 (10/97) CLAIM OF INTEREST ON VEHICLE SEIZED FOR FORFEITURE MCL 257.625n(6); MSA