Superior Court of California, County of Lassen Request/Notification for Courtroom Audio/Visual Presentation Equipment Attorney/Agency name: Requestors name: Telephone number: Cell number: Email: Alternate Contact: Alternate Telephone Number: Date(s) required: Start Time: End Time: Case number: Case name: Courtroom: Judicial Officer: Type of equipment requested: o Nomad Multimedia Unit w/Large Screen Function Needed: o o o o o o Overhead Projector VCR/VHS Player DVD Player CD Player Telephonic Polycom Unit Large Mobile Easel Other___________________________________ Other___________________________________ Notes:_____________________________________________________________ How many power hookups will be required for equipment brought in: Describe any additional equipment not on the list above: Internal use only Received by________ Date & Time__________ Date of Testing__________ Location_______________ Testing completed by_____________ Adopted for Mandatory Use 2-15-17 American LegalNet, Inc. www.FormsWorkFlow.com