SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE RULES (GR.030) Mandatory (A.D. 1-1-1) REQUEST/NOTIFICATION FOR COURTROOM AUDIO/VISUAL PRESENTATION EQUIPMENT SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE REQUEST/NOTIFICATION FOR COURTROOM AUDIO/VISUAL PRESENTATION EQUIPMENT YOUR NAME: CONTACT NUMBER: DATE(S) EQUIPMENT REQUIRED: START/END TIME: RESPONSIBLE PARTY FROM YOUR OFFICE: CONTACT NUMBER: CASE NUMBER: CASE NAME: LOCATION EQUIPMENT IS REQUIRED: JUDICIAL OFFICER HEARING CASE: TYPE OF EQUIPMENT TO BE USED: C OURT N ON C T PROJECTION Overhead Projector T ripod/Slide Projector Screen VIDEO VCR/VHS DVD TELECONFERENCING Teleconference TV Telephonic Polycom Unit (used for conference calls, up to 5 parties) EASEL Large Mobile Erase Large Mobile Reversible Erase Flip Chart Stand C OURT N ON C T OTHER S TANDARD X - R AY V IEWER TV WITH P ORTABLE S TAND S MALL W OODEN P OSTER S TAND NOMAD ( MULTIMEDIA UNIT ) AND L ARGE S CREEN **NOTE NOMAD ONLY TO BE USED IF M ULTIPLE FUNCTIONS NEEDED ** F UNCTION N EEDED : O VERHEAD P ROJECTOR A NNOTATION S CREEN AND P ROJECTOR DVD W / CD F UNCTION VCR X - R AY P ROJECTION O THER : O THER : O THER : Ot DESCRIBE ANY INTERFACING/COMPATIBILTY REQUIREMENTS BETWEEN THE EQUIPMENT YOU WILL PROVIDEAND THE EQUIPMENT YOU ARE REQUESTING THE COURT PROVIDE: HOW MANY POWER HOOKUPS WILL BE REQUIRED FOR ALL EQUIPMENT: DESCRIBE ANY ADDITIONAL EQUIPMENT NOT ON THE LIST ABOVE. YOU MAY ATTACH ADDITIONAL PAGES FOR YOUR DESCRIPTION: R EQUESTOR S S IGNATURE : D ATE : I NTERNAL U SE O NLY R ECEIVED B Y : D ATE : S CHE DULED /A SSIGNED BY : D ATE : T ESTING D ATE : T IME : L OCATION OF T ESTING : C OMPLETED ON : B Y : American LegalNet, Inc. www.FormsWorkFlow.com