REQUEST FOR COPY OF CERTIFICATE OF ANALYSIS Case No. (if known): ............................................................ Commonwealth of Virginia Va. Code § 19.2-187 ............................................................................................................ HEARING DATE AND TIME Charge: .......................................................................................... ................................................................................................................................................................ [ ] General District Court [ ] Circuit Court [ ] Juvenile and Domestic Relations District Court CITY OR COUNTY ...................................................................................................................................................................................................................................................................................................................... COURT ADDRESS [ ] Commonwealth of Virginia v. ............................................................................................................................................ DEFENDANT [ ] ............................................................................................... LOCALITY To the Clerk of the above-named Court: I, ..................................................................................................................................................................................... [ ] DEFENDANT , hereby request that a copy [ ] COUNSEL FOR DEFENDANT (PRINT NAME) of the certificate of analysis in the above-named case be sent to me at the following address: ............................................................................................................................................................................................................................................................................... .............................................................................................. ________________________________________________________ DATE SIGNATURE I certify that a copy of this request has been mailed or delivered to the Commonwealth’s Attorney of this jurisdiction on this ............................ day of .................................................................................................... , 20 .................................. . _____________________________________________________ [ ] DEFENDANT [ ] COUNSEL FOR DEFENDANT ................................................................................................................................................ TELEPHONE NUMBER OF [ ] DEFENDANT [ ] COUNSEL FOR DEFENDANT CERTIFICATION [ ] This case is not yet before this court. This request must be resubmitted. [ ] I certify that I have mailed or delivered a copy of such certification to the address provided in the above case, at no charge to the signator, on this ........................ .............................................................................................. DATE FORM DC-302 MASTER 10/08 day of .................................................................................. , 20 .......................... . ________________________________________________________ [ ] CLERK [ ] DEPUTY CLERK [ ] COMMONWEALTH’S ATTORNEY American LegalNet, Inc. www.FormsWorkflow.com