Request For Accommodations By Persons With Disabilities And Order
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Request For Accommodations By Persons With Disabilities And Order Form. This is a Washington form and can be use in Clark Local County.
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Tags: Request For Accommodations By Persons With Disabilities And Order, Washington Local County, Clark
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Index No.
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:
Plaintiff(s)
Calendar No.
JUDICIAL SUBPOENA
REQUEST FOR ACCOMMODATIONS BY PERSONS WITH
-against-DISABILITIES and ORDER
:
q
:
FORM TO BE KEPT CONFIDENTIAL (If box checked)
:
Applicant requests accommodation under Local Rule 0.4(b)
Defendant(s)
:
......................................................
Applicant Information
Applicant is: _ Witness
__ Juror
_ Attorney
_ Party
___ Other
THE PEOPLE OF THE STATE OF NEW YORK
Name:
court:
TO
Telephone:
Judge:
Address:
Case So.
GREETINGS:
1.
Type COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
_ Criminal
___ Civil
WE of proceeding.
,
the Honorable
at the
Court
Proceedings to be covered (e.g., bail hearing, preliminary hearing, particular witnesses at trial,
2.
located at
County of
sentencing hearing):
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
3.
Dates accommodations needed (specify):
or adjourned date, to testify and give evidence as a witness in this action on the part of the
4.
Impairment necessitating accommodations (specify):
5.
Type of accommodations (be specific):
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
6.
the partySpecial requests orthis subpoena was issued for a maximum penalty of $50 and all damages sustained as a
on whose behalf anticipated problems (specify):
result of Iyour failure tomy identity
_ not be kept confidential
7.
request that comply.
_ be kept confidential
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and
, one of the Justices of the
correct. Witness, Honorable
Court in
County,
day of
, 20
Date:
(Attorney must sign of Applicant)name below)
(Signature above and type
(Type or print name)
ORDER
Attorney(s) for
_ The request for accommodations is GRANTED because:
__ he applicant satisfies the requirements of the rule.
_ it does not create an undue burden on the court.
_ it does not fundamentally alter the nature of the service; program or activity
Office and P.O. Address
_ The request for accommodations is DENIED because:
___ the applicant does not satisfy the requirements of the rule.
_ it creates an undue burden on the court.
___ it fundamentally alters the nature of the service, program or activity. No.:
pam
Telephone
DATE:
JUDGE
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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