State of Alabama Unified Judicial System Form C-75B Rev. 7/2016 DETERMINATION ON REQUEST FOR COMPUTER BASED DATA OF THE UNIFIED JUDICIAL SYSTEM FROM THE ADMINISTRATIVE OFFICE OF COURTS (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 If denied, the reason(s) for denial is/are as follows: ________________________________________________________________________________________________ The estimated cost for fulfilling your request is: ________________________________________________________________________________________________ _______________________________ Date __________________________________________ Administrative Director of Courts DENIED 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 Requestor 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 REQUESTOR AGREES to use and distribute the information only as provided in the above referenced statement of intended use and distribution; the UNDERSIGNED REQUESTOR FURTHER AGREES to take reasonable precautions to prevent any disclosure of information beyond that stated; the UNDERSIGNED REQUESTOR 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 REQUESTOR 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 REQUESTOR ACCEPTS these and the following special conditions: 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 Administrative Director of Courts _________________________________________ Date ______________________________________________ Signature of Requestor ______________________________________________ Title ______________________________________________ Organization ______________________________________________ Date SWORN TO AND SUBSCRIBED before me this ______ day of __________, 20____. _____________________________________________ NOTARY PUBLIC My Commission Expires _________________________ American LegalNet, Inc. www.FormsWorkFlow.com