Photocopy Request

PHOTOCOPY REQUEST FORM UNITED STATES BANKRUPTCY COURT DATE OF REQUEST: ________________________ NAME: _____________________________________ ADDRESS: __________________________________ __________________________________ CASE NUMBER: ____________________ DEBTOR(S) NAME:_______________________ Copy requests must be paid in advance by cash, check or money order. NO DEBTOR CHECKS WILL BE ACCEPTED LIST BELOW THE SPECIFIC DOCUMENTS TO BE PHOTOCOPIED File Date of Document Document Number of Pages ______________ ______________ ______________ ______________ ______________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Total Number of Pages ______________ Total Cost at $.50 per Page ______________ ( ) Cash ( ) Check ( ) Money Order Please note that a Search Fee will be charged for a search of the Court's records. ( ) MAIL TO THE ABOVE ADDRESS ( ) IF YOU WISH TO PICK UP YOUR COPIES, PLEASE LEAVE A TELEPHONE NUMBER AND A CONTACT PERSON Contact Person: _______________________________ Phone Number: _______________________________ American LegalNet, Inc. www.FormsWorkFlow.com