Please submit this form to the appropriate UJS records manager. Contact information may be found on the UJS website under "Financial Records" at http://www.pacourts.us/T/AOPC/PublicAccessPolicy.htm RULE 509 REQUEST FORM Please Type or Print in Black or Blue Ink Name of Requestor Signature Mailing Address Street / PO Box Last First Middle Date City State Zip Code Telephone Number Email Address Fax Number Please identify each of the documents that are requested. It is important that your request be as specific as possible so that we may determine whether we have these documents. Note: Information related to standard fees and procedures may be found on AOPC's website http://www.pacourts.us/T/AOPC/PublicAccessPolicy.htm or relevant local court's website. Additional fees may be levied as necessary to cover costs incurred in fulfilling specific information requests. Pre-payment will be required if expected compliance costs exceed $100. Official Use Only CHARGE Comments Date Received Tracking Number (if applicable) Total Cost American LegalNet, Inc. www.FormsWorkFlow.com