Screen For VRA IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT STATE OF ALASKA ) ) ) Plaintiff, ) ) vs. ) ) ) ) CASE NO. CR Defendant. ) DOB: ) FINE EXTENSION REQUEST FOR FINE EXTENSION I, , request that the time for payment of my fine be extended because: Original Fine Amount $ . Defendant's Signature Mailing Address City State ZIP Work Phone Home Phone ----------------------------------------------------------------- APPROVAL The due date for payment of the fine in the above case is extended until . Date Judge/Deputy Clerk (under written authority granted by the court) Copy Distributed To Defendant on , 20 . CR-725 (1/06) (st.2) Clerk: FINE EXTENSION American LegalNet, Inc. www.FormsWorkFlow.com