Ala. R. Jud. Admin. Form C-75

State of Alabama

Unified Judicial System

Form C-75 10/08

APPLICATION AND REQUEST FOR

COMPUTER-BASED DATA OF THE UNIFIED

JUDICIAL SYSTEM FROM THE

ADMINISTRATIVE OFFICE OF COURTS

NOTICE TO REQUESTER:

This application, when submitted according to the procedures adopted by the Administrative Director of Courts, will be

processed and evaluated in accordance with Rule 33, Alabama Rules of Judicial Administration.

If you have made a request within the preceding six months for computer-based data which is substantially identical to

this request for information, your request will be denied. If your request is approved, costs will accrue in accordance with

the contract completed in conjunction with the approval of the request. Therefore, before submitting this application,

carefully consider whether the information requested will meet your needs and if it is required for your objective.

PART!.

DATE OF REQUEST:. ___________________________ _

NAMEOFREQUESTER.: ____________________________ _

ADDRESS OF REQUESTER:. _________________________ _

EMAIL ADDRESS:. ___________ _ PHONE NUMBER:. _________ _

(A). NAME OF PERSON OR ENTITY ON WHOSE BEHALF THIS REQUEST IS MADE:

(8). DESCRIBE INFORMATION REQUESTED (Be Specific):

(C). A SPECIFIC AND COMPLETE STATEMENT OF THE REASON(S) FOR THE REQUEST:

(D). A SPECIFIC AND COMPLETE STATEMENT OF ALL INTENDED USES OF THE INFORMATION:

(E). LIST PERSON(S) OR ENTITIES TO WHOM THE INFORMATION WILL BE

DISCLOSED OR DISTRIBUTED:

SIGNATURE OF REQUESTER/ TITLE