Christopher L. Austin Clerk United States Bankruptcy Court Eastern District of Wisconsin Office of the Clerk 126 U.S. Courthouse 517 E. Wisconsin Ave. Milwaukee, WI 53202-4581 414-297-3291 FAX 414-297-4040 www.wieb.uscourts.gov Federal Records Center File Request Date of request: ____________________________ Name of debtor: __________________________________________________________________________ Requested by: __________________________________________________________________________ Address: Case number: ______________________________ __________________________________________________________________________ ___________________________________________________________________________ Daytime phone #: __________________________________________________________________________ FOR OFFICE USE ONLY Amount paid: $ Case number: ______________________________ Box _____ of _____ Receipt number: ____________________________ Record accession number: __________________ Location number: __________________ Date ordered from Federal Records Center: _____________________________by:__________________________ Date file was viewed: ________________________Date file can be returned: ___________________________ Rev. June 3, 2005 American LegalNet, Inc. www.USCourtForms.com