STATE OF MICHIGAN
THIRD JUDICIAL CIRCUIT
WAYNE COUNTY
Family Domestic Emergency Filing
Cover Sheet
CASE NO.
This information below is for contact purposes only. In order to ensure your pleadings are properly filed, the Court
must be able to contact you. Please provide all necessary contact information. This information will not be given to
the other party.
Contact Information
Name: ___________________________________________
Address: ___________________________________________
___________________________________________
Phone #: ___________________________________________
____________________________________________
Email Address: ___________________________________________