CD Copy Request Order Form

CD COPY ORDER FORMCOMMONWEALTH OF MASSACHUSETTSTRIAL COURTHousing GCourtDivisionBoston GMunicipal Ct.DivisionSuperior GCourtDivisionJuvenile GCourtDivisionDistrict GCourtDivisionProbate & GFamily CourtDivisionLand G CourtPART I - TO BE COMPLETED BY PERSON PLACING ORDERNAME OF PERSON PLACING ORDERNAME OF CASEMAILING ADDRESS & ZIP CODEDOCKET NUMBER OF CASENUMBER OFCOPIES WANTEDBY THIS PERSONG 1G 2G 3EMAIL ADDRESSDATES OF RECORDINGS WANTEDPHONE NO: ( )MOST SERIOUS CHARGE IF CRIMINALIs proceeding is presently pending on appeal?G Yes; in order that multiple copies may be madesimultaneously whenever possible, I certify that Ihave notified all other parties of this request.G NoIf proceeding was not open to the public or itsrecord has been sealed or impounded: I certify that Ihave entered an appearance in this matter as: G counsel for , party, G a party appearing pro se,and that this copy will be used solely for an appeal,or to determine whether to appeal, in the samematter. (Copies of closed proceedings are available toother persons or for other purposes only uponmotion.)I agree to observe all restrictions on the use of CD copies found in applicable Rules of the Trial Court SIGNATURE OF PERSON PLACING ORDER DATEPART II - TO BE COMPLETED BY PERSON RECEIVING ORDERCOURT EMPLOYEE RECEIVING ORDERCOST WAIVED FOR:G Judge G D.A. G Police ProsecutorG Attorney provided by CPCS G c. 261, 247247 27A-27GDATE ORDER RECEIVEDDATE ORDER SENTG Other: PART III - TO BE COMPLETED BY STAFF OF AOTC TAPE DUPLICATION CENTERRECEIPT STAMPCOMMENTSDATE RETURNED TO COURTBYCOST (including postage)CDFORM 2011-09-28 American LegalNet, Inc. www.FormsWorkFlow.com