2. Case Number*
3. Court Date and Time*
   Court Date and Time

   Court Date and Time
5. Name
6. Email Address
7. Phone Number
9. Address
11. City
12. State
13. Zip Code
15. I am requesting a continuance of my scheduled court date due to the reason(s) listed below and I understand if approved, a new court date will be mailed to the address I have provided on this form. And, I understand the new court date may be scheduled as a virtual hearing or an in-person hearing

    1. I am a member of an immune-compromised population (or living in a household with someone who is immune-compromised)
    2. I am over age 65
    3. Within 14 days of my scheduled court date I or someone in my household experienced symptoms of COVID-19, have tested positive, or awaiting test results
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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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