Audio Request Form

THIS SECTION TO BE COMPLETED BY THE PERSON MAKING THE REQUEST After payment, five (5) working days required for completing request. TODAY'S DATE: PERSON MAKING REQUEST: CONTACT PHONE NUMBER: CASE NAME: CASE NUMBER(s): DATE(s) COURT PROCEEDING WAS HELD: TYPE OF PROCEEDING: TYPE OF MEDIA REQUESTED: COPIES TO BE ` ` CD TAPE Picked up at Jury Window on the 1st floor of the Justice Building. Mailed (only for people that do not live in Jackson County) to: THIS SECTION TO BE USED BY THE PERSON THAT WILL PROCESS THE REQUEST Request Taken By: Recorder: _ Judge: Due From: _ Courtroom #: Fill out this section prior to making copies. # of CD's or Tapes to be copied Cost of CD's or Tapes ($10 ec) Cost for copies of log (.25 per page) Cost of Faxing if applicable Cost of Postage if applicable Total Cost Due Date Notified of Amount Due Initials To be completed by Accounting. Amount Due Date Paid Receipt # Clerks to complete this section after copies are made. Date Completed Completed by: Date of Notification: Initials: In Person Picked up by: Left Message Date: Universal Audio Request 8/18/2011 American LegalNet, Inc. www.FormsWorkFlow.com