Traffic/Criminal Division - File an Appearance

Case No:

Offense Date(mm/dd/yyyy)

Plaintiff(s)

Defendant(s)

TO: Clerk of the Court, all attorneys of record, and unrepresented parties: Specify names and addresses.

I appear on behalf of

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Attorney
Court Appointed
Retained By

I hereby certify that I represent no other interest whatsoever of any party to this cause, except as follows:

Date(mm/dd/yyyy)

Signature

Name (type or print)

Bar No.

Address

Firm Name

City

State

Zip Code

Telephone Number(xxx-xxx-xxxx)

E–mail*

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