Collection Report Form
Complete the form and click “submit”.  Report forms are due by the 10th of each month
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Name *
Case Number *
Phone Number *
Mailing Address *
City *
State *
Zip Code *
Are you employed? *
If yes, name of Employer?
Employer's Address
Employer's City
Employer's State
Employer's Zip Code
Do you have a wage assignment? *
Did you make a payment today? *
If no, explain?
Do you want to enter into a wage assignment? *
If yes, how much PER PAY would you like sent to the court by your employer?
Any information you would like the magistrate to know regarding your current financial situation
NOTE:  This temporary procedure has been put in place for your protection.  Failure to report to me by completing the form EACH MONTH until your fines/costs are paid in full may subject you to an order to show cause and additional penalties, including possible suspension of your driver’s license and a bench warrant issued for your arrest.  If you need to speak to the magistrate or have a question, please call 989-672-3790 during business hours to speak to someone directly.
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