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2. Case Number*
4. Plaintiff Name:*
5. Defendant Name:*
7. Date*
   Date
9. Attorney for:
   -- Select One --PlaintiffDefendantOther
11. First Name*
12. Last Name*
16. Motions*

    1. Completed
    2. Needed and shall be filed
18. Motion to be filed within how many days?*
22. Issues:
24. Defenses:
26. Pleadings:
28. Admissions:
32. Experts for:*

    1. Plaintiff
    2. Defendant
    3. None
34. Expert name and field expertise *
38. Witnesses for:*

    1. Plaintiff
    2. Defendant
    3. None
40. Provide name of each witness*
42. Damages
46. Exhibits
    NOTE: All exhibits must be submitted to court recorder prior to commencement of trial or they will not be admitted.
48. Remarks
50. Additional Information:*

    1. NUMBER OF HOURS REQUESTED FOR TRIAL
    2. JURY TRIAL
    3. NON-JURY TRIAL
    4. ALREADY SCHEDULED
    5. OTHER
    6. NONE
52. Provide details for selected box(s)
56. Please Note:
    - If Jury: Voir Dire, Instructions and brief required three (3) days in advance. If non-jury: Brief must be submitted no later than 2 weeks before trial.
58. PLEASE ADVISE OF SETTLEMENT TEN (10) DAYS PRIOR TO TRIAL DATE
60. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. I have reviewed this document and the statements it contains are true to the best of my knowledge, information, and belief.

    1. I agree.
62. Electronic Signature*
63. Bar # if applicable
65. *Discovery shall be in accordance with Michigan Court Rules*
66. 60DC-160 Rev 6/17
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68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit Submit and Print

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