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Ordering Paralegal: E-mail Address: * For Attorney: Representing: Firm Name: Order Date: Need By Date: Trial Date: Client Matter No.: Third Party Billing Information: Name of Person: ALIAS/AKA: DOB: DOD: SSN: Type of Request: Authorization w/Affidavit Subpoena (Admissible) Subpoena (Inadmissible w/Affidavit) Affidavit of No Records if no records Other, please specify Rush Approval: Regular request Rush / FedEx (not approved) Rush / FedEx (approved) Case style to appear on legal documents: vs. Case Number: Court: In the County/Parish: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, DC West Virginia Wisconsin Wyoming --Territories-- American Samoa Federated States of Micronesia Guam Midway Islands Puerto Rico U.S. Virgin Islands Please list locations and record type: Attach a File: Please provide any special instructions: * Required