UNITED STATES DISTRICT COURT DISTRICT OF MARYLAND OFFICE OF THE CLERK Reply to Northern Division Address CHANGE OF ADDRESS FORM FOR SELF-REPRESENTED PARTY Name: Address: City/State/Zip: Telephone: Fax Number: Email Address: Case Number(s), if any: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ Date: _______________________________________________________ ChangeofAddressProSe (06/2016) Northern Division � 4415 U.S. Courthouse � 101 W. Lombard Street � Baltimore, Maryland 21201� 410-962-2600 Southern Division � 240 U.S. Courthouse � 6500 Cherrywood Lane � Greenbelt, Maryland 20770 � 301-344-0660 Visit the U.S. District Court's Web Site at www.mdd.uscourts.gov American LegalNet, Inc. www.FormsWorkFlow.com