Fillable INSTRUCTIONS Prior to submitting any application, read the (Vermont Judiciary)

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INSTRUCTIONS Prior to submitting any application, read the (Vermont Judiciary)

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600-00054 Amendment to Permanent Registration
INSTRUCTIONS
F
orm 600-00054: Amendment to Permanent Media Registration
Prior to submitting any application, read the superior court rule and Supreme Court rule
regarding devices and the accompanying administrative order.
Review the different applications and choose the correct form.
Submit application as indicated in the instructions.
1. This form allows media individuals/organizations to amend a permanent registration
certificate.
2. The form can be used to update contact information and remove or add authorized
persons.
3. The existing registration certificate must be filed with the completed form.
4. An updated registration certificate will be sent by email if authorized persons are added
or removed.
600-00054 Amendment to Permanent Registration
STATE OF VERMONT
Amendment to Permanent Media Registration
Send completed application to: jud.mediaregistration@vermont.gov
You must attach a copy of the existing permanent media registration certificate for the
organization named below.
Name of Organization: ____________________________________________________ Name
of Person Completing Application: _________________________ Title: _____________ I am
requesting the following change(s):
The following contact information (leave blank if there is no change):
Mailing address: _________________________ Telephone: ____________________________
New Email Address of Primary Registrant: __________________________
New Email Address of Authorized Person _____________ (name) to _________________
Remove this authorized person(s):
Name
Title
Email Address
Add this authorized person(s):
Name
Title
Email Address
An updated permanent media registration certificate will be sent if authorized persons are
added or removed.
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INSTRUCTIONS Prior to submitting any application, read the (Vermont Judiciary)

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Completed 30 July 2020

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