TO: Clerk's Office UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK ________________________________________ APPLICATION FOR LEAVE TO FILE DOCUMENT UNDER SEAL A) If pursuant to a prior Court Order: Docket Number of Case in Which Entered:___________________ Judge/Magistrate Judge:__________________________________ Date Entered:___________________________________________ _____________________ Docket Number ****************************************** SUBMITTED BY: Plaintiff____ Defendant____ DOJ ____ Name:__________________________________________ Firm Name:______________________________________ Address:_________________________________________ ________________________________________________ Phone Number:___________________________________ E-Mail Address:___________________________________ INDICATE UPON THE PUBLIC DOCKET SHEET: YES NO __ ****************************************** -v- B) If a new application, the statute, regulation, or other legal basis that authorizes filing under seal __________________________________________________________ __________________________________________________________ ORDERED SEALED AND PLACED IN THE CLERK'S OFFICE, AND MAY NOT BE UNSEALED UNLESS ORDERED BY THE COURT. DATED: , NEW YORK If yes, state description of document to be entered on docket sheet: U.S. DISTRICT JUDGE/U.S. MAGISTRATE JUDGE RECEIVED IN CLERK'S OFFICE___________________________ DATE MANDATORY CERTIFICATION OF SERVICE: A.) ___ A copy of this application either has been or will be promptly served upon all parties to this action, B.) ___ Service is excused by 31 U.S.C. 3730(b), or by the following other statute or regulation:______; or C.) ____This is a criminal document submitted, and flight public safety, or security are significant concerns. (Check one) __________________ DATE ______________________________ SIGNATURE American LegalNet, Inc. www.FormsWorkFlow.com