EXEMPTION FORM I am counsel of record for ___________________ in the following appeal or appeals (Case Numbers and Captions): ______________________________________________________________________________ ______________________________________________________________________________ I hereby request an exemption from the court's requirement that all attorneys participate in the CM/ECF filing system. The basis for my request is: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________ Name _______________________________________ Address _______________________________________ _______________________________________ Phone Number ________________________________________ Fax Number Action (Approved or Denied) _____________________ Michael E. Gans Date:________________ American LegalNet, Inc. www.FormsWorkflow.com