IN THE SUPREME COURT FOR THE STATE OF MICHIGAN

PEOPLE OF THE STATE OF MICHIGAN, Supreme Court No

Plaintfff-Appellee,

ttM name you ware convictSai (pAnttMi [underonmtsune:}

Defendant-Appellant.

(Leave blank.)

Court Of Appeals No M " ? ? ? / (From Court of Appeals decision.) .

Trial CourtNo. H^Mii3^4^J^(l (See C

4835-3318 CSJ-318 05/02

Please PR!NT clearly Hlegible ai^d/oT incomplete forms witi not be processed.

Lock ~ Institution

Prisoner Number Prisoner Name (Print Clearly)

a t e g a l Postage ' • Filling Fee $ • Certified Mail (Must Be a Court Ordered Requirement)

New Case Qcase Number .VA-(TAplM^ Q t=a L/ase I^JUI i luei _j i—i^,r^ • — ' Pay T . . ry^-Y ' \ A \ r \ ; ^ . . ^uftr.>>^ ^0--^^,

Mailing Address:.

T H . fnllnwina section must be c o m p l a t e d l ^ i o n z i n g Staff Member's presence.

Prisoner Signature: ••• • ^ ' • • • ' , . i

Received By •̂ 'T)/ } •, .-. / ' {Print Name & Title): — ^ J r ^ 1^^,^.^:^-;^=-^:^-^—^

Date & Time Submitted

staff Signature:

Date & Time Received by Authorizing

Authorization Dented:

• Does not meet definition of legal mail or court filing fee as identified in CFA OP'05.03.118.

• New case or case number not on form.

ignature:

• Not hand delivered to authorizing staff member.

• Does not include court order for handling as certified mail. • Other

• 'Prisoner refused to sign & date in staff member's presence. : r — . :• Q o n t m n heiow to be Completed by Mail Rpom Staff

... I f Placed in Mail by - , (Print Name STiUe): \ ^

ostaqe Amount:^ - Date & ^rr ie placed in outgoing M a l l i ^

Only Business Office Staff are to Write in the Sectio>^eloW

Obligation Amount Actual Expense' • Court filing Fee Denied due to NSF.

Date Posted:

Processed By (PrintNameS Title);

^d/^ Signature:

Date & Time Copy Sent to Prisoner:

f^anarv - Prisoner Pink - Counselor's File Goldenrod - Prisoner

MICHIGAN DEPARTMENT OF CORRECTIONS DISEURSEMErx!TA>UTHORlZATEOM(EKPiOETEO LEGAL L....= . Please PREHT cfearSy il legible and/or incomplete forms wil l not be processed.

Lock

4835-3318 CSJ-318 05/02

nstitution

Prisoner Number

Legal Postage

New Case

Prisoner Name (Print Clearly)

• Certified Mail (Must Be a Court Ordered Requirement)

Mailing Address:

• Filling Fee S

Case Number ffli^^'^H £ £ e IJ | uase numoer * ' \-'-^\!'^ •—i—

Pay To: ^C^^^A TAA - A ^ ^ ^ . V ^ c r vxV^f irtrlroQ-5- Q nl 3 1 ("jiW (X

T . . ..ii„,.,inn , . r t inn must be c o m p l i i ^ Authorizing Staff Member's presence.

Prisoner Signature;

Received By (Print Names Title): _

Date & Time Submitted:

•:( Staff Signature:

Date & Time Received by Authorizing Staff:

Authorization Denied:

• Does.not meet definition of legal mail or court filing fee as Identified in CFA OP 05.03.118.

^ . •. • „ . ^ • New case or case number not on form. • Not hand delivered to authonzing staff member. ^

• Does not include court order for handling as certified mail. ^ Other

• Prisoner refused to sign & date in staff member's presence. Section beldw to be completed by Mail Room StaH

Placed in Mali by . .. (Print Name & Title):'

, ; Signature: _

Postage Amount: $ ( T ^ J ^ ' Dat^ ^T ime placed in outgoing M a i l : -Only Business Office Staff are to Write in the Section Below

Obligation Amount. ."Actual Expense • Court filing Fee Denied due to NSF.

Processed By P y (Print Name & Title): ^—^

Date Posted:

Date & Time Copy Sent to Prisoner:

A ^ ^ f -T^-WIU^- 'V L^J{y

legal Mall and Court Filing Fee t^book- MailRoom/Coritrol Center Facility: .

t O J J " " J ' - "

C A J - 6 1 7 0 3 / 0 2

Monthly Report:

TypVof., Disbursement.̂ ^

Housing % Unit' Staff

1

;Goiirt Doclcet .Number or "new ̂ case" J Postage

l i l ingfce ^ Date/TnUfi^T^' ;disbursementifi faxed or hand -delivered'^toi^j Business Office ^

1 iling Fee r'Daifc/tnnf!;/ check J " 'jeceiyed^-:^ from ^ \ i Business

o>);so»g,̂ „«a.Ki«,S 'FJ>** + ̂ Outgomg •••.ri..':L.. L'liiui-k

-V-:,',.?':i:^-'il.''.;-

Office f{

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