Fill and Sign the Mc 510 Order on Media Request to Permit California Courts Form

FOR COURT USE ONLY MEDIA AGENCY (name): CHANNEL/FREQUENCY NO.: PERSON SUBMITTING REQUEST (name): ADDRESS: TELEPHONE NO.: Insert name of court and name of judicial district and branch court, if any: TITLE OF CASE: NAME OF JUDGE: MEDIA REQUEST TO PHOTOGRAPH, RECORD, OR BROADCAST CASE NUMBER: PORTION OF THE PROCEEDINGS TO BE COVERED (e.g., particular witnesses at trial, the sentencing hearing, etc.): (File this form at least five court days before the DATE OF PROPOSED COVERAGE (specify): TYPE OF COVERAGE Audio TV camera and recorder a. d. Still camera Other (specify): b. e. Motion picture camera 4.SPECIAL REQUESTS OR ANTICIPATED PROBLEMS (specify): 5. INCREASED COSTS. This agency acknowledges that it will be responsible for increased court-incurred costs, if any, resulting from this media coverage (estimate): $ Amount unknown PROPOSED ORDER. A completed, proposed or der on Judicial Council form MC- 510 is attached (required by Cal. Rules of Court, rule 1.150). CERTIFICATION I certify that if the court permits media coverage in this case, all participating personnel in this media agency will be infor med of and will abide by the provisions of California Rules of Court, rule 1.150, the provisions of the court order, and any additional re strictions imposed by the court. Date: (SIGNATURE) (TYPE OR PRINT NAME) Telephone No.: (SUPERVISORY POSITION IN MEDIA AGENCY) NOTICE OF HEARING ( A hearing is optional.) A HEARING will be held as follows: Date: Time: Room: Dept./Div.: Address of the Court: Clerk, by , Deputy Form Adopted for Mandatory Use Judicial Council of California MC-500 [Rev. January 1, 2007] MEDIA REQUEST TO PHOTOGRAPH, RECORD, OR BROADCAST Cal. Rules of Court, rule 1.150 www.courtinfo.ca.gov proposed coverage date. If not feasible , explain good cause for noncompliance): 2. 3. 1. 6.c. ............................................................................. . MC-500