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FOC 22

Employer's Disclosure of Health Insurance and/or Income Information

Michigan · Michigan State Court Administrative Office · Effective June 1, 2022

This form asks an employer to provide detailed information about an employee's income, health insurance, and other financial details. It is used to gather specific financial records for the court.

The court describes it as: Court rule / statute: MCL 552.518

Open the official PDFfrom Michigan State Court Administrative Office

Where this fits in a case

General & info

Information / general use — not tied to one step of a case

This form is used when the court needs detailed financial information from an employee's employer, as required by Michigan law, likely in a case involving support or finances.

Prepared by the court or clerk.

Common questions

Who needs to fill out this form?
The form is a notice to the employer, meaning the employer is required to complete and return it to the friend of the court.
What kind of information is collected?
It collects details about the employee's pay, income sources, retirement contributions, and information about health and dental insurance offered.
Is this form used in every case?
The form references Michigan law (MCL 552.518) and is used for purposes related to administering and enforcing state and federal laws governing child support.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect June 1, 2022.

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