Merced — MSC-AD-011

Source: https://www.merced.courts.ca.gov/system/files/forms-and-filings/ada-compl-msc-ad-011-court-audio-video-equip-request-form-rev-72026.pdf

Court Audio-Video Equipment Request Form

Case Name: Case Number:

Scheduling Information Date: Time: Courtroom:

Contact Information Name: Organization:

Work Phone: Cell Phone:

E-Mail Address:

Requested Equipment: VCR Player CD Player Audio Tape Player (Cassette) DVD Player Laptop (audio/video files player)

Signature I understand that this document must be completed and submitted at least two court days in advance. I acknowledge that any changes to scheduling information or requested equipment require the submission of an amended form at least two court days prior to the scheduled date. I further understand that this request does not guarantee the availability of equipment and is subject to approval by Court Administration,

SIGN

Name (printed): Signature:

Date:

For Court Administration Use Only

Date: Approved Denied

Reason:

FOR MANDATORY USE Page 1 of 1 MSC-AD-011 [Rev. June 30, 2026]