ORDERING INSTRUCTIONS:

PLEASE FOLLOW THESE GUIDELINES WHEN USING THIS ORDER FORM:

(We can assure excellent service if you follow these guidelines.)

*PLEASE FILL IN ALL APPLICABLE SPACES AND MARK ALL APPLICABLE BOXES

PATIENT INFORMATION: Fill in this section completely. Every item should be used to complete the Notice of Dismissal.

REQUESTED BY: Fill in this section completely, this information will also be used to complete the Notice of Dismissal.

CASE INFORMATION: Make sure to include a Case Number.

OPPOSING COUNCIL AND PARTIES TO BE NOTIFIED: Fill in this section completely and be sure to include any relevent entries from your mailing list, if you want us to notify the interested parties.

DELIVERY TO: Complete this section with the address, city, and zip code of the APPLICANT.

OTHER SERVICES PROVIDED BY: Supportive Legal Services. Check appropriate box if any of these services are needed. We will gladly provide more information regarding these services on request. Just call our customer service department.

SPECIAL INSTRUCTIONS: Be specific and use the special instruction section of the order form when you need to provide us with special information or when you require services not listed on this form. Use this section if you want us to notify the interested parties in the action. Also, you can use this section if you want us to send the copies of the Notice of Dismissal via FIRST CLASS or CERTIFIED MAIL.

To make a copy for your records, use your web-browser's print function (usually located under the browser's 'File' drop-down menu) after the Order Form is completed (but BEFORE you actually send it via the "Send Order Now" button). Should you require additional help or information please contact our Customer Service Department, or your Account Representative. Feel free to send us your Order(s), Authorization(s) or other correspondence by FAX to (818) 841-9738.

THANK YOU FOR CHOOSING SUPPORTIVE LEGAL SERVICES.