PC 664 is the Petition for Authority to Place Individual with Developmental Disability in a Facility, a Michigan probate court form approved by the State Court Administrative Office (SCAO). A guardian uses it to ask the court for authority to admit the individual to a center or facility, either temporarily or by administrative admission. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the court publishes the original PDF at courts.michigan.gov.
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What is PC 664?
Form PC 664, Petition for Authority to Place Individual with Developmental Disability in a Facility, is a Michigan probate court petition in which a guardian asks the court to authorize admitting an individual with a developmental disability to a center or facility.
The form is approved by the State Court Administrative Office (SCAO) and carries the SCAO JIS code PDA. It is headed "State of Michigan, Probate Court," with a county and a file number, and it names the individual in the matter of "an individual with a developmental disability."
The petition lets the guardian choose among three kinds of admission in item 3:
- a temporary admission, for a period not to exceed 30 days, to a named center to receive clinical services;
- an admission of up to 10 days to a named center for a preadmission examination and a subsequent administrative admission if suitable;
- an admission to a named facility.
Item 6 then requests authority to execute the necessary applications for the administrative admission of the individual to a named facility. The form states that a report and evaluation required by law and court rule is filed with it, lists all interested persons in the proceeding, and ends with a declaration under the penalties of perjury.
The legal references printed on the form are MCL 330.1100b, MCL 330.1509, MCL 330.1510, MCL 330.1623 and MCR 5.746. A use note says that when the form is filed in the circuit court family division, the court name and county go in the upper left-hand corner.
Who needs to file PC 664?
The form is written for a guardian of an individual with a developmental disability. Item 1 reads "I ... am interested in this matter and make this petition as guardian of the individual," so the petitioner states that role on the form.
You use PC 664 if, as guardian, you need the court's authority to:
- admit the individual temporarily, for no more than 30 days, to a center for clinical services;
- admit the individual for up to 10 days to a center for a preadmission examination and a subsequent administrative admission if suitable; or
- execute the necessary applications for the administrative admission of the individual to a named facility.
The form has signature blocks for an attorney (with name and bar number) and for the petitioner. It also asks you to list every interested person in the proceeding, with age, relationship, address and telephone number, and to note any who are under legal disability. It is not a general placement form: it concerns an individual with a developmental disability and the facilities named in items 3 and 6.
When to file PC 664
File PC 664 when, as guardian, you need the court's authorization before admitting the individual to a center or facility. The form sets no calendar deadline of its own. Its time limits concern the admission itself: a temporary admission for clinical services may not exceed 30 days, and a preadmission examination stay is for up to 10 days, with a subsequent administrative admission if suitable.
Because item 4 says the required report and evaluation is filed with the petition, have that report and evaluation ready at the time you file. For any timing rule beyond what the form prints, check MCR 5.746 and the other provisions cited at the bottom of the form, or ask the court.
Documents you need
- The report and evaluation required by law and court rule, filed with the petition as stated in item 4 of the form.
How to fill out PC 664
Enter court, county and file number
At the top, enter the county in "County of" and leave the file number to the court. If the form is filed in the circuit court family division, write the court name and county in the upper left-hand corner.
Name the individual
In the line "In the matter of," enter the name of the individual with a developmental disability.
Identify yourself as guardian
In item 1, enter your name as the person making the petition as guardian of the individual.
Enter the individual's residence
In item 2, enter the address where the individual presently resides: street address, city, state and ZIP code.
Select the admission requested
In item 3, complete the line that applies: 3a for a temporary admission of no more than 30 days for clinical services, 3b for up to 10 days for a preadmission examination, or 3c for admission to a facility. Enter the name and location of the center or facility.
Confirm the report and evaluation
Item 4 states that the report and evaluation required by law and court rule is filed with this petition. Have it ready to file with the form.
List all interested persons
In item 5, enter each interested person's name, age, relationship, street address, city, state, ZIP code and telephone number. The form asks for all of them and notes any under legal disability.
Name the facility in your request
In item 6, enter the name of the facility to which you request authority to execute the necessary applications for administrative admission.
Sign, date and add attorney details
Sign and date as petitioner under the penalties of perjury declaration, and add your address, city, state, ZIP code and telephone number. If an attorney is involved, the attorney signs and gives name, bar number and address.
Review and download the completed PDF
Check names, addresses and the item 3 selection, then download or print the completed PDF from FillingPDF. File it with the report and evaluation as described under How to submit.
How to submit PC 664
The form names no filing channel of its own. It is a petition to the Michigan probate court shown at the top, so it is filed with that court, in the county where the matter is pending, under the file number printed in the upper right of the form.
- Court and county: the heading reads "State of Michigan, Probate Court, County of." Enter the county. If the form is filed in the circuit court family division, the use note says to enter the court name and county in the upper left-hand corner.
- With the petition: item 4 states that a report and evaluation required by law and court rule is filed with it, so file them together.
- Signatures: the petitioner signs, and the attorney signs if one is representing the petitioner, before filing.
- Court use only: leave the area below the "Do not write below this line" mark empty.
The form does not give a street address, portal or fee information. Contact the clerk of the court for how it accepts filings and whether a fee applies. FillingPDF lets you fill out and download the PDF; submission follows the court's channels.
Common mistakes to avoid
- Filing the petition without the report and evaluation; item 4 states that it is filed with the petition.
- Leaving the list of interested persons in item 5 incomplete; the form asks for all of them, with age, relationship, address and telephone number.
- Choosing a temporary admission in item 3a that exceeds 30 days, or a preadmission stay in item 3b that exceeds 10 days.
- Omitting the court name and county in the upper left-hand corner when the form is filed in the circuit court family division.
- Writing in the area below the line marked "Do not write below this line - For court use only."
- Leaving the petitioner signature or date blank on a petition that declares its contents true under the penalties of perjury.
- Naming a different facility in item 6 than the one the petition seeks to authorize, or leaving item 6 empty.
- Not stating that you are the guardian in item 1, which is the capacity in which the petition is made.
Frequently asked questions
What is PC 664?
PC 664 is the Petition for Authority to Place Individual with Developmental Disability in a Facility, a Michigan probate court form approved by SCAO. A guardian uses it to ask the court for authority to admit the individual to a center or facility, temporarily or by administrative admission.
Who can file the PC 664 petition?
The form is made by a guardian of the individual: item 1 says the petitioner is interested in the matter and petitions as guardian. It also has a signature block for an attorney, who adds a name and bar number.
What are the three admission options on PC 664?
Item 3a is a temporary admission to a center for clinical services for up to 30 days. Item 3b is an admission of up to 10 days to a center for a preadmission examination, with administrative admission afterward if suitable. Item 3c is an admission to a named facility.
What must be filed with PC 664?
Item 4 states that a report and evaluation required by law and court rule is filed with the petition. The form does not list other attachments, so confirm anything further with the court that will hear the matter.
Who has to be listed in item 5 of PC 664?
Item 5 asks for all interested persons in the proceeding, none of which are under legal disability except as noted. For each, enter name, age, relationship, street address, city, state, ZIP code and telephone number.
Can I fill out PC 664 online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the petition; you file it with the Michigan court yourself.
What if the petition is filed in the circuit court family division?
The use note on the form says to enter the court name and county in the upper left-hand corner. The printed heading otherwise reads State of Michigan, Probate Court.
Which laws does PC 664 cite?
The form lists MCL 330.1100b, MCL 330.1509, MCL 330.1510, MCL 330.1623 and MCR 5.746. Read those provisions or ask the court for guidance on requirements beyond what the form prints.
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