JACKSON COUNTY CIRCUIT COURT THIS SECTION TO BE COMPLETED BY THE PERSON MAKING THE REQUEST After payment, five (5) working days required for completing request Today's Date: PERSON & ADDRESS MAKING REQUEST: COPIES TO BE: Picked up at Jury Window on the 1st floor of the Justice Building. Mailed (only if not living in Jackson County) to: CONTACT PHONE NUMBER: CASE NAME: CASE NUMBER(s): DATE(s) COURT PROCEEDING WAS HELD: TYPE OF PROCEEDING: THIS SECTION TO BE USED BY THE PERSON THAT WILL PROCESS THE REQUEST Request taken by: Recorder: Judge: Courtroom: Cost of CD's ($10.00 each) Cost for copies of log (.25 per page) Total Cost Due Initials # of CD's to be copied To be completed by Accounting Clerks to complete this section after copies are made Date Completed Completed by: Date of Notification Initials In Person Left Message Picked up by: Date: Audio Request -JAC Page 1 of 1 6/20/14 American LegalNet, Inc. www.FormsWorkFlow.com