[ Home ] [ Page 1 ] [ Page 2 ] [ Page 3 ] [ Page 4 ]

I CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE, ALL OF THE ABOVE INFORMATION IS TRUE AND CORRECT.

___________________________________
Lead Counsel/Pro Se Party 		______________________________
Date

Representing: _______________________

 

Certificate of Service

I hereby certify that a true and correct copy of the foregoing Docketing Statement was served this ______ day of _______________, 19____, on all parties/attorneys of record listed below (provide name and address of each person served and if person served is party's attorney, list name of party attorney represents) by: (circle one) personal service, mail, commercial delivery service, fax. See TRAP 9.5(b).

 

____________________________________
Lead Counsel/Pro Se Party

[ Back ] Rev. 9/2/97