Petitioners Motion To Seal Address And Telephone Number {3DC01}

PETITIONER'S MOTION TO SEAL ADDRESS AND TELEPHONE NUMBER IN THE DISTRICT COURT OF THE THIRD CIRCUIT DIVISION STATE OF HAWAI`I Petitioner Form #3DC01 Reserved for Court Use Civil No. Respondent SS Filing Party/Attorney Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Fax Numbers (Petitioner - leave this box blank) PETITIONER'S MOTION TO SEAL ADDRESS AND TELEPHONE NUMBER DECLARATION I DECLARE UNDER PENALTY OF PERJURY THAT THE FOLLOWING IS TRUE AND CORRECT. l. 2. I am the Petitioner. I am requesting that the Court seal my address and/or telephone number because (state facts why you are making the request): Signature of Petitioner: Date: Reserved for Court Use Print/Type Name(s): COURT ORDER This motion is: GRANTED DENIED Date: Judge: In accordance with the Americans with Disabilities Act , and other applicable State and Federal laws, if you require an accommodation for your disability when working with a court program, service, or activity please contact the District Court Administration Office at PHONE NO. 961-7424, FAX 961-7411, OR TTY 961-7422 at least (10) working days in advance of your hearing, or appointment date. Reprographics (01/10) American LegalNet, Inc. www.FormsWorkFlow.com 3D-P-256