Fifteenth Judicial Circuit Approved Local Form, Designation of Email Address for Self Represented Litigants- (1/17)
IN THE CIRCUIT/COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
CASE NO.:
,
Plaintiff/Petitioner
v.
,
Defendant/Respondent.
NOTICE OF DESIGNATION OF EMAIL ADDRESS FOR E-SERVICE
I, (full legal name) , designate my e-mail address(es)
below (up to 3 different email address) to opt in E-service in this case.
Primarily Email Address: ____________________________________________________
Secondary Email Address: _________________________________________________
Other Email Address: ____________________________________________________
1. By completing this form I am authorizing the Court, the Clerk of the Fifteenth Judicial
Circuit of Florida and the opposing party to send copies of orders/judgment, notices or
other written communications or pleadings to me through my designated e-mail and NOT
through regular U.S. Mail.
2. I understand that I must keep the clerk's office and the opposing party or parties notified of
my current mailing and e-mail address(es) and that all future orders/judgment, notices or
other written communications or pleadings in this lawsuit will be served at the email
address(es) provided above.
3. I will ensure the software filters have been removed from my computer, so it does not
interfere with my ability to receive any of the above documents.
I certify that a copy of this document was {check all used}: ( ) e-mailed ( ) mailed ( ) faxed
( ) hand-delivered to the person(s) listed below on {date} .
Other party or his/her attorney
Name:
Address:
City, State, Zip:
Fax Number:
E-Mail Address(es):
Dated:
Signature of Party
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signature
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Fifteenth Judicial Circuit Approved Local Form, Designation of Email Address for Self Represented Litigants- (1/17)
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE
BLANKS BELOW:
[fill in all blanks] This form was prepared for the: {choose only one}
( ) Petitioner ( )Respondent
This form was completed with the assistance of:
{name of individual}
{name of business}
{street}
{city} , {state} {telephone number}