| Firm Name : | |
| Attorney/Examiner: | |
| Phone: | |
| Date: | |
| Time: | |
| Duration: | |
| Proceeding Type: | |
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Job Location Name: | |
| Street Address: | |
| Suite: | |
| City: | |
| State: | |
| ZIP: | |
| Phone at Location: | |
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| Is This a Telephonic Deposition? | Yes
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| | No |
| Capacity: | |
| Contact Person: | |
| Would you like Alliance to book your conference room? | |
| If yes, what city? | |
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| Deponent/Witness Name: | |
| Time: | |
| Deponent/Witness Name: | |
| Time: | |
| Deponent/Witness Name: | |
| Time: | |
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| Bill Your Firm? | Yes |
| | No |
| Billing Company: | |
| Adjuster's Name: | |
| City: | |
| State: | |
| File or Claim No.: | |
| Date of Loss: | |
| Client's Reference #1: | |
| Client's Reference #2: | |
| Insured: | |
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| Do You Require a Videographer? | |
| Do You Want RealTime? | |
| Do You Want a Rough Disk? | |
| Do You Want Hookup? | |
| Will an Interpreter be Present? | |
| Do you need Transcript Expedited? | |
| Other Comments | |
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| Scheduler's Name: | |
| Scheduler's E-mail Address: | |
| Scheduler's Phone Number: | |
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