© 2020 Family Law Self-Help Center Request for Video Appearance
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ATEAR
Name:
Address:
Telephone:
Email Address:
In Proper Person
DISTRICT COURT
CLARK COUNTY, NEVADA
________________________________
Plaintiff,
vs.
________________________________
Defendant.
CASE NO.: ____________________
DEPT: ____________________
HEARING DATE: ______________
TIME OF HEARING: ____________
VIDEO APPEARANCE REQUEST
(Your name) _________________________________________, ( check one) Plaintiff
/ Defendant, requests that the following person be allowed to testify by remote court
appearance via video conference, pursuant to Rule 4 of the Nevada Supreme Court’s Rules
Governing Appearance by Audiovisual Transmission Equipment: ( check one) Myself /
Witness: __________________________________. This request is for the hearing date and
time above for the ( check one):
Motion Hearing
Case Management Conference
Trial / Evidentiary Hearing
Trial Setting Conference
Other: _________________________
The person subject to this request has executed the Consent on the next page and agrees
to be bound by the oath given by the Court Clerk, Eighth Judicial District Court and to be
subject to the jurisdiction of this Court for purposes related to this testimony.
(Your Name) _______________________________ agrees to provide all exhibits to the
witness in advance in the same form as have been or will be submitted to the Court Clerk.
Any objection to this request must be made in writing within two (2) judicial days of
service of this request.
© 2020 Family Law Self-Help Center Request for Video Appearance
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If the IT department wants to test and verify the functionality of the party/witness’s
video conference connectivity with the Court’s IT department, the contact information of the
party or witness for the test is:
Name: _________________________________________
Email Address: __________________________________
Phone Number: __________________________________
DATED (today’s date) ___________________________, 20___
Submitted By: (Signature)_________________________________
Printed Name: _________________________________
CONSENT
(to be signed by the person who wants to appear by video)
By making this request for Audiovisual Transmission Equipment Appearance, the
undersigned agrees to be bound by the oath given by the Court Clerk over the video conference
connection and to be subject to the jurisdiction of this Court for purposes related to this
testimony. I certify that the video connection has been successfully tested at
http://bluejeans.com/111, prior to submitting this application.
Pursuant to NRS 53.045, I declare under penalty of perjury that the foregoing is true
and correct.
DATED (today’s date) ___________________________, 20___
(Signature of party or witness)_________________________________
Printed Name: _________________________________
/s/
/s/
© 2020 Family Law Self-Help Center Request for Video Appearance
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CERTIFICATE OF SERVICE
I, (your name) _________________________________ declare under penalty of perjury
under the law of the State of Nevada that I served the Audiovisual Transmission Equipment
Appearance and Audiovisual Transmission Equipment Consent in the following manner:
Mail: By depositing a copy in the U.S. Mail in the State of Nevada, postage prepaid, on
the (day) ________ of (month) _________________, 20___ addressed to:
(Print the name and address of the person you mailed the document to)
Name:
Address:
City/State/Zip:
Electronic: Through the Court’s electronic service system on (date) ________________
at (time) ___________ □ a.m. □ p.m.
DATED (today’s date) ___________________________, 20___
Submitted By: (Signature)_________________________________
/s/