TO: Clerk's Office UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK _________________________________________ APPLICATION FOR LEAVE TO FILE DOCUMENT UNDER SEAL ************************ -v.­ C C C C _________________ C Docket Number C C C A) If pursuant to a prior Court Order: Docket Number of Case in Which Entered:___________________ Judge/Magistrate Judge:______________________ Date Entered: __________________ B) If a new application, the statute, regulation, or other legal basis that authorizes filing under seal ************************ SUBMITTED BY: Plaintiff____ Defendant ____ DOJ____ Name:____________________________________ Firm Name:_______________________________________ Address:__________________________________________ _________________________________________________ Phone Number:____________________________________ E-Mail Address:________________________________ ______________________________________________________ ______________________________________________________ ORDERED SEALED AND PLACED IN THE CLERK’S OFFICE, AND MAY NOT BE UNSEALED UNLESS ORDERED BY THE COURT. DATED: , NEW YORK _____________________________________________________ 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) _________________ __________________________________ American LegalNet, Inc. DATE SIGNATURE www.FormsWorkflow.com