<table>
<colgroup>
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 11%" />
<col style="width: 2%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2" rowspan="2"></td>
<td colspan="14"><strong>U.S. Bankruptcy Court Eastern District of
Kentucky</strong></td>
<td colspan="8"><strong>FOR COURT STAMP ONLY</strong></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="12" rowspan="2"><strong>PLEASE COMPLETE ENTIRE FORM
TRANSCRIPT REQUEST</strong></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="12">1. NAME</td>
<td colspan="4">2. PHONE NUMBER</td>
<td colspan="8">3. DATE</td>
</tr>
<tr class="odd">
<td colspan="12"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="12">4. MAILING ADDRESS</td>
<td colspan="4">5. CITY</td>
<td colspan="5">6. STATE</td>
<td colspan="3">7. ZIP CODE</td>
</tr>
<tr class="odd">
<td colspan="12"></td>
<td colspan="4"></td>
<td colspan="5"></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="6">8. CASE NUMBER</td>
<td colspan="6">9. JUDGE ASSIGNED</td>
<td colspan="12">DATES OF PROCEEDINGS</td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td colspan="6"></td>
<td colspan="3">10. FROM</td>
<td></td>
<td colspan="3">11. TO</td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="12">12. CASE NAME</td>
<td colspan="12">LOCATION OF PROCEEDINGS</td>
</tr>
<tr class="odd">
<td colspan="12"></td>
<td colspan="2">13. CITY</td>
<td colspan="2"></td>
<td colspan="4">14. STATE</td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="24">15. ORDER FOR</td>
</tr>
<tr class="odd">
<td>G</td>
<td colspan="5">APPEAL</td>
<td>G</td>
<td colspan="5">CRIMINAL</td>
<td>G</td>
<td colspan="4">CRIMINAL JUSTICE ACT</td>
<td></td>
<td colspan="6">BANKRUPTCY</td>
</tr>
<tr class="even">
<td>G</td>
<td colspan="5">NON-APPEAL</td>
<td>G</td>
<td colspan="5">CIVIL</td>
<td>G</td>
<td colspan="4">IN FORMA PAUPERIS</td>
<td>G</td>
<td colspan="4">OTHER <em>(Specify)</em></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="24" rowspan="2">16. TRANSCRIPT REQUESTED (Specify
portion(s) and date(s) of proceeding(s) for which transcript is
requested)</td>
</tr>
<tr class="even">
</tr>
<tr class="odd">
<td colspan="8">PORTIONS</td>
<td colspan="4">DATE(S)</td>
<td colspan="4">PORTION(S)</td>
<td colspan="8">DATE(S)</td>
</tr>
<tr class="even">
<td>G</td>
<td colspan="7">Entire hearing</td>
<td colspan="4"></td>
<td>G</td>
<td colspan="3">TESTIMONY (Specify Witness)</td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>G</td>
<td colspan="7">Witness</td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>G</td>
<td colspan="7">Witness</td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>G</td>
<td colspan="7">Witness</td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>G</td>
<td colspan="7">Ruling of the Court only</td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="7"></td>
<td colspan="4"></td>
<td>G</td>
<td colspan="3">OTHER (Specify)</td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="7"></td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="7"></td>
<td colspan="4"></td>
<td colspan="4"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="24">17. ORDER</td>
</tr>
<tr class="odd">
<td colspan="3" rowspan="3">CATEGORY</td>
<td colspan="5">ORIGINAL</td>
<td colspan="3" rowspan="3">FIRST COPY</td>
<td rowspan="3"><p>ADDITIONAL</p>
<p>COPIES</p></td>
<td colspan="4" rowspan="3"></td>
<td colspan="8" rowspan="3"></td>
</tr>
<tr class="even">
<td colspan="5">(Includes Free Copy</td>
</tr>
<tr class="odd">
<td colspan="5">for the Court)</td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">ORDINARY</td>
<td colspan="5"></td>
<td colspan="3"></td>
<td>NO. OF COPIES</td>
<td colspan="4" rowspan="2"></td>
<td colspan="7" rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td>G</td>
<td colspan="3"></td>
<td></td>
<td>G</td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">EXPEDITED</td>
<td colspan="5"></td>
<td rowspan="2"></td>
<td></td>
<td rowspan="2"></td>
<td>NO. OF COPIES</td>
<td colspan="4" rowspan="2"></td>
<td colspan="7" rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td>G</td>
<td colspan="3"></td>
<td>G</td>
<td></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">OVERNIGHT</td>
<td colspan="5"></td>
<td rowspan="2"></td>
<td></td>
<td rowspan="2"></td>
<td>NO. OF COPIES</td>
<td colspan="4" rowspan="2"></td>
<td colspan="7" rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td>G</td>
<td colspan="3"></td>
<td>G</td>
<td></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2"></td>
<td colspan="5"></td>
<td rowspan="2"></td>
<td></td>
<td rowspan="2"></td>
<td></td>
<td colspan="4" rowspan="2"></td>
<td colspan="7" rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td colspan="3"></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="12">18. SIGNATURE</td>
<td colspan="12">PROCESSED BY</td>
</tr>
<tr class="odd">
<td colspan="12">19. DATE</td>
<td colspan="12">PHONE NUMBER (859) 233-2608</td>
</tr>
<tr class="even">
<td colspan="12">TRANSCRIPT TO BE PREPARED BY</td>
<td colspan="12">COURT ADDRESS</td>
</tr>
<tr class="odd">
<td colspan="12" rowspan="4">(VENDOR LABEL HERE)</td>
<td colspan="12" rowspan="6"><p><strong>U.S. Bankruptcy Court Eastern
District of Kentucky</strong></p>
<p><strong>P.O. Box 1111</strong></p>
<p><strong>Lexington, KY 40588-1111</strong></p></td>
</tr>
<tr class="even">
</tr>
<tr class="odd">
</tr>
<tr class="even">
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="3">DATE</td>
<td>BY</td>
</tr>
<tr class="even">
<td colspan="8"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="8">ORDER RECEIVED</td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="8">REQUEST SENT TO SERVICE</td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="8">TRANSCRIPT RECEIVED</td>
<td colspan="3"></td>
<td></td>
<td colspan="4"></td>
<td colspan="7"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="24"></td>
</tr>
</tbody>
</table>

DISTRIBUTION: COURT COPY TRANSCRIPTION COPY ORDER RECEIPT ORDER COPY

COMPLETE, PRINT, SIGN, and SEND TO ATTN: KELLY, U.S. Bankruptcy Court
Eastern District of Kentucky, P.O. Box 1111, Lexington, KY 40588-1111

Questions? Call Kelly at (859) 233-2608, x135