Fill and Sign the Form C 75a

State of Alabama Unified Judicial System Form C-75A Rev. 6/2018 REQUEST FOR COMPUTER-BASED DATA OF THE UNIFIED JUDICIAL SYSTEM FROM THE ADMINISTRATIVE OFFICE OF COURTS NOTICE TO REQUESTER: This application, when submitted accord ing to the procedures adopted by the Administrative Director of Courts, will be processed and evaluated in accordance with Rule 33, Alabama Rules of Judicial Administration. If you have made a request within the preceding six months for co mputer based data whic h is substantially identical to this request for information, your request w ill be denied. If your request is approved, costs will accrue in accordance with the contract; therefore, before submitting th is application, carefully consider whether the information requested will meet your needs and if it is required for your objective. PART I. DATE OF REQUEST: _____________________________________________________________________________ _______________________________________________________________________________________________ NAME OF REQUESTER ________________________________________________________________________\ ______________________ ADDRESS OF REQUESTER CITY STATE ZIP CODE _____________________________________________ ____________________________________________ PHONE N UMBER _______________________________________________________________________________________________ NAME OF PERSON OR ENTITY ON WHOSE BEHALF THIS REQUEST IS MADE DESCRIBE INFORMATION REQU ESTED (Be Specific): REASON THE INFORMATION IS WANTED: SPECIFY HOW THE INFORMATION WILL BE USED: LIST PERSON(S) OR ORGANIZATION(S) TO WHOM THE INFORMATION WILL BE DISCLOSED OR DISTRIBUTED: _______________________ ____________________ SI GNATURE OF REQUESTER E-MAIL ADDRESS