CIV107 State ENG Rev 3/09www.mncourts.gov/formsPage 1 of 1State of Minnesota District Court County Select County Judicial District: Court File Number: Case Type: Plaintiff (first, middle, last) Defendant (first, middle, last)vs.Stipulation For Use of Interactive Television Minn. Gen. R. Prac. 131The parties, through their counsel, stipulate and requests that (describe motion) scheduled for hearing on ato'clock .m. be heard by interactivetelevision (ITV). The parties also certify that the use of ITV will be in accordance with the provisions of Rule 131 of the General Rules of Practice for the District Court, including, without limitation, the requirement that no recording shall be made of any ITV proceeding except the recording made as the official court record. Signature of Counsel for Plaintiff Dated: Dated: Signature of Counsel for DefendantAPPROVAL The court, upon review of the file and stipulation of the parties, approves the use of interactive television for the above hearing pursuant to the Protocol for Use of ITV in Civil Cases in District Court. Judge of District Court Dated: American LegalNet, Inc. www.FormsWorkFlow.com