In the District Court of ______________________ County State of Oklahoma Dispute Resolution System Collections Report Collections for the month of _______________________, 20______. Type of Case Number of Cases Divorce Adoption License (except marriage) Civil (Less than $10,000) Civil (More than $10,000) Guardianship Small Claims All Other Civil Total = x $2.00 = $ Total Amount Submitted = $ _____________________________________ Court Clerk _____________________________________ Date This form and the collections are to be submitted to the Administrative Office of the Courts, 1915 N. Stiles, Suite 305, Oklahoma City, Oklahoma, 73105, by the tenth of each month. Do not include en forma pauperous cases. AOC Form 16 Revised 8/05 American LegalNet, Inc. www.USCourtForms.com