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Request for Media Access/Coverage
Agency & Case Information
Name of Media Group/Agency

 
Name of Media Representative:

 
Address:
Address Cont.
City:
State:
Zip:
Email Address:
Phone:
Fax:
     
Case Name:
Case Number:
Date of Hearing:
Hearing Time:
     
Designated Representative
Nature of Request:
Media Type Audio      Video      Still Photography
     
  I/We agree to comply with all of the conditions set forth in Administrative Order No. 2015-00044, Rule 122 and Rule 123.

 I/We Agree
Title:
Date:
   
   
Requests must be submitted at least 2 business days prior to the proceeding.
 


 
 

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