Request to bring in Electronic Equipment

Your Name (required):

Your Email (required):

Your Phone Number (required):

In which Courthouse(s) will service be performed? (required)
 Wilkie D. Ferguson Jr Courthouse, 400 North Miami Avenue, Miami, Florida 33128
 C. Clyde Atkins Courthouse, 301 North Miami Avenue, Miami, Florida 33128
 James Lawrence King Federal Building, 99 NE 4th Street, Miami, Florida 33132
 US Federal Building and Courthouse, 299 Broward Boulevard Fort Lauderdale, Florida 33301
 Paul G. Rogers Federal Building and United States Courthouse, 701 Clematis Street West Palm Beach, Florida 33401
 U.S. Post Office and Courthouse, 301 Simonton Street Key West, Florida 33040
 Fort Pierce U.S. Courthouse, 101 South U.S. Highway 1 Fort Pierce, Florida 34950

Location within Courthouse service to be performed? (Example-Chambers 12-1, Executive Office, etc) (required)

Date(s) of Service (required):

Time(s) of Service (required):

Company/Agency performing service (required):

Purpose of Courthouse Visitation or Scope of Work (required):

Name(s) and Tile of individual(s) performing service (required) and Clearance Level (if applicable):

List all electronic equipment for each person entering the Courthouse(s) for this service (example: John Doe, Cell phone, beeper, laptop. Jane Doe, laptop) (required):

Why do listed individuals need this electronic equipment? (required):

Who will escort/supervise? (required):