For Clerk’s Use Only Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, Zip Code: _______________________________________ Daytime Phone Number: _______________________________________ Evening Phone Number: _______________________________________ ATLAS Number (if applicable):______________________________________ Attorney Bar Number (if applicable): ________________________________ Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY ________________________________________ (Name of Petitioner/Plaintiff) Case Number:____________________________ ORDER FOR HISTORICALLY SIGNIFICANT CASE DESIGNATION AND _________________________________ (Name of Respondent/Defendant) This Court has examined the Motion submitted by (individual filing motion) __________________________ to designate the above captioned case as historically significant pursuant to Arizona Code of Judicial Administration §3-402(F)(1). It is the opinion of this Court that the request for historical case designation should be [ ] granted [ ] denied. IT IS THEREFORE ORDERED this case [ ] shall [ ] shall not be designated as historically significant and should be managed consistent with the provisions of the record retention schedule pursuant to the case type. IT IS FURTHER ORDERED that the Motion and this Order be placed in the official case record. DATED: _____________________________ _____________________________________________ JUDGE OF THE SUPERIOR COURT 12/28/2007 American LegalNet, Inc. www.FormsWorkFlow.com