SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE REQUEST FOR COURTROOM AUDIO/VISUAL PRESENTATION EQUIPMENT REQUESTOR INFORMATION: Your Name: Date(s) Equipment Required: Start Time: End Time: Case Number: Case Name: Contact Number: Responsible Party from Your Office: Contact Number: Location Equipment is Required: □ BCCH □ Chico □ Paradise Judicial Officer Hearing Case: DESCRIBE ANY/ALL EQUIPMENT YOU WILL BE PROVIDING AND ANY POWER HOOKUPS REQUIRED: TYPE OF EQUIPMENT REQUESTED FROM COURT: Projection □ Overhead Projector □ Tripod/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 □ Medium Mobile Erase □ Small Tripod Erase □ Flip Chart □ Tripod Flip Chart Other □ Standard X-Ray Viewer □ TV with Portable Stand □ Small Wooden Poster Stand □ NOMAD (multimedia unit) and large screen **NOTE -NOMAD only to be used if multiple functions needed** Function needed: □ Overhead Projector □ Annotation Screen and Projector □ DVD w/ CD Function □ VCR □ X-Ray Projection DESCRIBE ANY INTERFACING/COMPATABILITY REQUIREMENTS BETWEEN THE EQUIPMENT YOU WILL PROVIDE AND THE EQUIPMENT YOU ARE REQUESTING THE COURT PROVIDE: REQUESTOR’S SIGNATURE: _____________________________________________DATE: _________________ INTERNAL USE ONLY RECEIVED BY: _____________ DATE: _______ SCHEDULED/ASSIGNED BY: _____________ DATE: _______ TESTING DATE: _______TIME: _____ LOCATION OF TESTING: _______ COMPLETED ON:_______ BY: ________ ___________________________________________________________________________________________________________________________ (RUL-1-GR-030) (E.D. 7-1-2009) Mandatory REQUEST FOR AUDIO/VISUAL PRESENTATION EQUIPMENT American LegalNet, Inc. www.FormsWorkFlow.com