DISTRICT COURT OF MARYLAND FOR Located at STATE OF MARYLAND OR Plaintiff Court Address City/County Case No. Trial Date vs. Defendant Address City, State, Zip Address City, State, Zip REQUEST It is requested that: Date Signature Printed Name Address Telephone Fax E-mail ORDER PURSUANT TO A REQUEST After consideration, the Request made by on Granted Denied Comments: is: Date Judge ID Number DC-001 (Rev. 10/2014) American LegalNet, Inc. www.FormsWorkFlow.com