Law & Courts Building, 60296 M-62, Cassopolis, MI 49031 269-445-4416
Plaintiff’s name, address and telephone number:
____________________________________
____________________________________
____________________________________
____________________________________
Defendant’s name, address and telephone number:
____________________________________
____________________________________
____________________________________
____________________________________
Pursuant to MCR 3.215(E)(8), the parties waive their right to object to the referee’s recommendation to
enter an order by consenting in writing to the immediate entry of the recommended order.
Therefore, the undersigned acknowledge that the signatures by both parties constitute a waiver of the
parties’ right to object to the referee’s recommended order/judgment and acknowledge that this will allow for
immediate entry of the order/judgment by the Judge.
Date:_____________
Plaintiff’s signature
Plaintiff’s printed name
Unless represented by an attorney or present at the hearing, the Defendant must have his/her
signature notarized.
Date:_____________
Defendant’s signature
Defendant’s printed name
Subscribed & sworn to before me on the ____ day of ________________, 20____, __________________ County, MI.
Signature_____________________________________, Notary Public, State of Michigan, County of
_________________________. My commission expires:_______________.
Date:_____________
Signature by Attorney for Plaintiff
Date:_____________
Signature by Attorney for Defendant
