Fill and Sign the And Affidavit of Proper Use Form

Form 801Rev.12/17 1 of 1 The Family Court of the State of Delaware In and For New Castle Kent Sussex County REQUEST FOR ELECTRONIC COPY OF AUDIO RECORD AND AFFIDAVIT OF PROPER USE 1.I certify that I am a party/authorized attorney in the matter in which I am requesting an electronic copy of the audio record. 2. I am requesting an electronic copy of the hearing held on at a.m. , before  .3. I certify that I will pay all costs associated with the preparation of the electronic copy on compact disc (CD) of the audio record. Each CD contains an electronic copy of the audio record from only one hearing. The fee for each hearing is $25.00. Date Signature I declare under penalty of perjury that: 1. My purpose in requesting an electronic copy on compact disc of the audio record of my hearing before the Family Court is to review the record of this hearing. 2. I will not copy, alter, transfer or otherwise use in an inappropriate manner such electronic copy of the audio record of my hearing in the Family Court. a.Inappropriate use includes, but is not limited to using the Electronic Copy of the CD for the purposes of harassment, embarrassment, entertainment, inflicting emotional distress, exploitation, blackmail, loss of employment, and/or commercial gain. 3. I understand that inappropriate use of such electronic copy may implicate criminal offenses enumerated in Title 11 of the Delaware Code. Date Signature SWORN AND SUBSCRIBED TO before me on this day of , Clerk of Court/Notary PublicApplicant / Attorney Name File Number or Criminal Case Number Street Address P.O. Box Number Petition Number City/State/Zip Code Phone Number Petitioners Name Respondents Name 500 N. KING STREET WILMINGTON, DE 19801(302) 255-0300 400 COURT STREET DOVER, DE 19901(302) 672-1000 22 THE CIRCLE GEORGETOWN,DE 19947(302) 855-7400