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CC 404Mandatory

Notice to Prisoner on Application for Leave to Appeal Decision of Parole Board

Michigan · Michigan State Court Administrative Office · Effective April 1, 2021

This form is a notice that tells a prisoner that someone has filed an application with the circuit court asking for permission to appeal a decision made by the Parole Board. It informs the prisoner about the filing and who needs to receive copies of the documents.

The court describes it as: Court rule / statute: MCL 791.234(11), MCR 7.118(D)(3)

Open the official PDFfrom Michigan State Court Administrative Office

Where this fits in a case

Appeal

Stage: Appeal

This form is used when an application for leave to appeal a decision from the Parole Board is being filed with the circuit court.

Either party may file.

Common questions

Who needs to receive copies of this notice?
The notice must be distributed to the prisoner, the Parole board, the Prosecutor/Victim, the Prison/Facility, and the Court.
Does the prisoner have to respond to this application?
The form states that the prisoner is not required to respond to the attached application, but they can respond themselves or hire an attorney.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect April 1, 2021.

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