UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF VIRGINIA OFFICE OF THE CLERK Date of Request ______________________________ Case Name__________________________________ Case No.____________________________________ or Name of Requestor______________________________ Address ______________________________________ ______________________________________ Telephone No. (____)___________________________ AP No. ____________________________________ COPY REQUEST FORM for Online (Electronic) and Paper-based Case Files, Certified Copies, or Government Agency Photocopies in paper-based Case Files FEES: Search Fee $30.00 if request made other than in person Copy Fee $.50 per page Certified Copies. Identify document(s) to be certified: ______________________________ $11.00 per document plus $ .50 per page copy fee Make check payable to Clerk, U.S. Bankruptcy Court. Amount Due $_______________________ Please submit this form to the Clerk's office. If received at the Clerk's Office by 2:00 p.m., together with payment of appropriate fees, document requests within electronic cases are normally completed and available for pickup after 10:00 a.m. the next business day. Document requests in non-electronic cases will be processed and/or available for pickup within two business days following receipt of request if file is located at the court. If file is not available, you will be notified by telephone at the number listed above. Please indicate below under "Delivery Method" your preferred method for receiving these documents upon completion of your request by the Clerk's Office. DOCUMENT DESCRIPTION Please check ( X ) documents to copy: DATE FILED DOCKET ENTRY# NO. OF PAGES ______ Petition _________________________________________________________________________________ ______ Schedules _______________________________________________________________________________ ______ Statement of Financial Affairs _______________________________________________________________ ______ Notice of Meeting of Creditors (341 Notice) _____________________________________________________ ______ Discharge ________________________________________________________________________________ ______ No Distribution Report _____________________________________________________________________ ______ Order Closing Case ________________________________________________________________________ ______ Chapter 13 Plan ___________________________________________________________________________ ______ Petition Package __________________________________________________________________________ (Statement of Financial Affairs & Schedules A ­ J) ______ Entire File _______________________________________________________________________________ ______ OTHER ­ Give Description: _________________________________________________________________ DELIVERY METHOD Pick up at Clerk's Office (Requests not picked up within 10 days will be destroyed.) Mail it to the address provided above (A self-addressed, stamped envelope of adequate size and postage is attached to this request.) Overnight Service (Federal Express or UPS package and pre-paid Air Bill is attached to this request.) FOR OFFICE USE ONLY Total # of copies __________ Amount Paid: $ ______________ Date Paid: _____________ Receipt #: __________ Search Fee $ ________________ Copy Fee $ ________________ Certified Copy Fee $ ________________ Date/Time Request Received: _______________________________ Date Picked Up/Mailed: _______________ American LegalNet, Inc. www.FormsWorkFlow.com