Request For Videotape Or CD Copy

State of Michigan REQUEST FOR Case No. th 7 Judicial Circuit VIDEOTAPE/CD COPY 900 S. Saginaw St. Flint, MI 48502 (810) 424-4436 Plaintiff name(s) Defendant name(s) v Plaintiffs attorney, bar no., address, telephone no. Defendants attorney, bar no., address. telephone no. I request a copy of the videotape recording of the proceeding specified below a copy of the digital recordin g of the proceeding specified below Judge Date of proceeding Time of proceeding Type of proceeding Special instructions (specify whether request is for a complete transcript or a portion of the transcript) ____________________ ________________________________________ Date Signature ________________________________________ Name (type or print) ________________________________________ Address ________________________________________ City, State, Zip Telephone no. _______________________________________________________________________________ FOR COURT USE ONLY: Paid: Yes No Pay when video is picked up Wait for check in mail Date payment was received: __________________________________ Cash Check Number ________________ Amount $________________ _______ G:\forms\reqvideo