CRM903 State ENG Rev 8/18 www.mncourts.gov/forms Page 1 of 1 State of Minnesota District Court County Judicial District: Court File Number: Case Type: Criminal State of Minnesota , Agreement to Visual or Audio Coverage Minn. Gen. R. Prac. 4.02(e)(iv) Plaintiff vs Defendant I am [ ] a victim in this case as defined by Minn. Stat. 247 611A.01(b) or [ ] a person giving a statement on behalf of the victim as the victim222s proxy. I understand the media is proposing to cover the proceedings in this case by visual or audio means. I agree to visual or audio coverage of any statement I provide at the upcoming hearing(s) in this case. Dated: Signature Print Name: American LegalNet, Inc. www.FormsWorkFlow.com