Stipulation for ContinuanCe in the DiStriCt Court of the fifth CirCuit State of hawai`i Plaintiff(s) Form #5DC12 Reserved for Court Use Civil No. Defendant(s) Filing Party(ies)/Filing Party(ies)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Facsimile Numbers) Court Date & Time (if any): Return Pre-Trial None Trial Other:___________________ Stipulation for ContinuanCe All appearing parties enter a STIPULATION FOR CONTINUANCE in the above-entitled matter for the following reason(s): (Attach continuation page, if necessary). By signing this document, we acknowledge that if approved, the new court date is: Date: ____________________Time:______ a.m. or p.m. Return Pre-Trial Other: ____________________________ (All appearing parties must sign below.) Signature of Plaintiff(s)/Plaintiff(s)' Attorney: Date: Print/Type Name: Signature of Defendant(s)/Defendant(s)' Attorney: Date: Print/Type Name: Approved Denied Date: Judge of the above-entitled Court In accordance with the americans with Disabilities act if you require an accommodation for your disability, please contact the District Court Administration Office at PHONE NO. 482-2347, FAX 482-2509, OR TTY 482-2533 at least (10) working days in advance of your hearing or appointment date. RepRogRaphics (03/09) American LegalNet, Inc. www.FormsWorkFlow.com coNTsTi 5D-p-178