ATTORNEY/FIRM REQUEST FOR EXCLUSION FROM ELECTRONIC FILING OF REQUEST FOR EXEMPTION FROM DOCKET MANAGEMENT PROGRAM DISMISSAL STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov JD-CL-87 Rev. 12-06 INSTRUCTIONS 1. Type or print clearly. 2. File this form with the Court Operations Unit no later than January 12, 2007. 3. Keep a copy of this form for your records. TO: Court Operations Unit, 225 Spring St., Wethersfield, CT 06109 Tel. 866 765-4452 FROM (Name of attorney/law firm requesting exclusion) JURIS NO. ADDRESS OF ATTORNEY/LAW FIRM TELEPHONE (with area code) REASON FOR REQUEST FOR EXCLUSION I hereby request that I/the law firm named above be excluded from the requirement of electronically filing through E-Services the Request for Exemption from Docket Management Program (DMP) Dismissal for the following reason(s): SIGNED (Attorney making request) NAME OF ATTORNEY SIGNING AT LEFT DATE X CERTIFICATION DATE I hereby certify that a copy hereof was mailed/delivered to all counsel and pro se parties of record on: SIGNED (Attorney making request) NAME OF EACH PARTY SERVED* TELEPHONE NO. (with area code) ADDRESS AT WHICH SERVICE WAS MADE *If necessary, attach additional sheet with names of each party served and the address at which service was made. FOR COURT OPERATIONS USE ONLY - DO NOT WRITE BELOW THIS LINE FILE DATE The request has been considered and is hereby: GRANTED - You may file a request for exemption from the Docket Management Program in hard-copy form. Attach a copy of this form to each Request for Exemption from the Docket Management Program. DENIED - You must file a request for exemption from the Docket Management Program electronically through E-Services. SIGNED (Judge/Caseflow Management Specialist) DATE SIGNED American LegalNet, Inc. www.FormsWorkFlow.com