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Type of Accommodation

Accomodation Typepick one!
If "Other" is chosen, please specify

Party Requesting Assistance

(Contact information for the person filling out this form)

First Name
Last Name
Phone

Person Needing Assistance

(Contact information for the party needing services)

First NameFirst Name (assistance)
Last NameLast Name (assistance)
Phone NumberPhone Number (assistance)

How is the person needing assistance related to the case?

Partypick one!
If "Other" is chosen, please specify

Date & Time Assistance is Needed

Dateof appointment
Time
Estimated Length of Event

Mode of Hearing

Mode of Hearingpick one!
Zoom Meeting ID & Passcode (if you have one)

Case Information

(Please type "Jury” in the field below if your request is for Jury Duty)

Case Number
Type of Eventpick one!
If "Other" is chosen, please specify

Location of Appearance

Locationpick one!
Courtroom Number

Presiding Judge

Name of Judge (if known)your full name
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