SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Form No. PL-CW007 Effective 01-01-2019 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, and Address): TELEPHONE NO.: FAX NO.: EMAIL ADDRESS: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF PLACER 10820 Justice Center Drive 2501 N. Lake Blvd. P.O. Box 619072 P.O. Box 5669 Roseville, CA 95661-9072 Tahoe City, CA 96145 PETITIONER/ PLAI NTIFF: RESPONDENT /DEFENDA NT : REQUEST FOR COURT REPORTER CASE NUMBER: TO THE CLERK OF THE COURT: I request that a court reporter be provided for my hearing on: Date: Time: Department: Estimated Length of Hearing: I have a valid fee waiver dated: . DATE: Signed: Plaintiff/Petitioner Defendant/Respondent American LegalNet, Inc. www.FormsWorkFlow.com