Fill and Sign the Risk of Suicide Deliberate Self Harm and Psychiatric Illness Form

Do not write below this line - For friend of the court use only PC 618 (6/17) PERSONAL REPRESENTATIVE NOTICE TO THE FRIEND OF THE COURT MCL 700.3705(6) Approved, SCAO PERSONAL REPRESENTATIVE NOTICE TO THE FRIEND OF THE COURT Estate of , decedent 1. The decedent’s identifying information is Name, date of birth, and last 4 digits of SSN . 2. As required by MCL 700.3705(6), I am providing the friend of the court, in the county where this estate is being administered, with the names and addresses of the decedent’s surviving spouse and the devisees (testate estate) or the heirs (intestate estate) . The estate is being administered in County. The probate court file number is . 3. Name, date of birth, and last 4 digits of SSN of surviving spouse Name, date of birth, and last 4 digits of SSN of devisee/heir Address Address City, state, zip City state, zip Name, date of birth, and last 4 digits of SSN of devisee/heir Name, date of birth, and last 4 digits of SSN of devisee/heirAddress Address City, state, zip City, state, zip Name, date of birth, and last 4 digits of SSN of devisee/heir Name, date of birth, and last 4 digits of SSN of devisee/heirAddress Address City, state, zip City, state, zip Personal respresentative signature Attorney name (type or print) Bar no. Personal representative name (type or print) Address Address City, state, zip Telephone no. City, state, zip Telephone no. I certify that on this date I mailed a copy of this notice to the friend of the court office in this county by first-class mail. Date Signature Instructions to the Personal Prepresentative: This notice should be completed and provided to the friend of the court in the county where the decedent’s estate is being administered within 28 days of your appointment. CERTIFICATE OF MAILING