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Prepare Fax Filing Cover Sheet

Docket Number:  

Case Style:  

Title of Document:  

Attorney:  First Name:    Last Name:  

Attorney's Address:  

Attorney's City:  

Attorney's State:    Zip:  

Attorney's Phone Number:    Attorney's Fax Number:  

Email Address:  

Re-enter Email Address:  

Date Faxed:  

Total pages, including cover page:    (Cannot exceed 50 pages unless authorized by Court.)

Your service charge pursuant to T.R.C.P 5A.04 is $ 


Please use the "Prepare Coversheet" button to print this coversheet. The printed version has a barcode that is needed in order to process your payment.

Thank you.