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 I. DATE OF REQUEST:_____________________________________________________________________________ NAME OF REQUESTER:__________________________________________________________________________ ADDRESS OF REQUESTER:______________________________________________________________________ EMAIL ADDRESS:_______________________________ PHONE NUMBER:__________________________ (A). NAME OF PERSON OR ENTITY ON WHOSE BEHALF THIS REQUEST IS MADE: (B). 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 American LegalNet, Inc. www.FormsWorkflow.com APPLICATION AND REQUEST FOR COMPUTER-BASED DATA OF THE UNIFIED JUDICIAL SYSTEM FROM THE ADMINISTRATIVE OFFICE OF COURTS Form C-75 (Back) 10/08 PART II. (AOC USE ONLY) TO BE COMPLETED BY THE ADMINISTRATIVE DIRECTOR OF COURTS DATE REQUEST RECEIVED:__________________________________________________________________ You are hereby notified that your application has been processed and evaluated in accordance with Rule 33, Alabama Rules of Judicial Administration, and it is GRANTED DENIED If denied, the reason(s) for denial is/are as follows:______________________________________________________ The estimated cost for fulfilling your request is:_________________________________________________________ _______________________________ Date __________________________________________ Administrative Director of Courts CONTRACT IT IS UNDERSTOOD that the Administrative Office of Courts, the Administrative Director of Courts, or UJS personnel are not responsible for any errors in the information supplied to the Requester and are not liable for any use or disclosure of said information beyond that stated on the application attached hereto and incorporated by reference as if set out word for word. The Administrative Director of Courts agrees to provide the information requested, and the UNDERSIGNED REQUESTER AGREES to use and distribute the information only as provided in the above-referenced statement of intended use and distribution; the UNDERSIGNED REQUESTER FURTHER AGREES not to sell any information or data received pursuant to this request; the UNDERSIGNED REQUESTER FURTHER AGREES to take reasonable precautions to prevent any disclosure of information beyond that stated; the UNDERSIGNED REQUESTER FURTHER AGREES that the documented method of retrieving the information is adequate and will sufficiently fulfill the request and that any requested changes in the method will necessitate submitting an entirely new application; the UNDERSIGNED REQUESTER FURTHER AGREES to pay, unless payment has been waived, the estimated cost with return of this contract and, upon fulfillment of the request, to pay the difference if the charges are more than the estimated cost, with the understanding that a refund will be made if the charges are less; and finally, the UNDERSIGNED REQUESTER ACCEPTS these and the following special conditions: The parties agree that the UNDERSIGNED REQUESTER shall bear the cost of compiling the data requested and the Administrative Office of Courts shall not provide such information until payment of all costs incurred in compiling the information is received. Such costs shall include, but not be limited to, a reasonable per hour charge for the work of computer programmers required to write the code or other software or programs necessary to compile, capture, and display the data compilation requested. IT IS FULLY UNDERSTOOD that the violation of any of the terms of this contract or failure to return this contract within fifteen (15) days of receipt will result in withdrawal of approval and denial of this request. _________________________________________ Signature of Administrative Director of Courts _______________________________________________ Signature of Requester, Title _________________________________________ Date _______________________________________________ Organization _______________________________________________ Date SWORN TO AND SUBSCRIBED before me this ______ day of __________, 20____. _________________________________________ NOTARY PUBLIC Judicial Administration Rule 33 AL R J ADMIN Rule 33 American LegalNet, Inc. www.FormsWorkflow.com