Secured Leave Form

STATE OF NORTH CAROLINA CHATHAM File No County In The General Court Of Justice Superior Court Division Additional File Numbers: Name/Address Of Attorney: Telephone Number Email Address: Attorney Bar Number: Name/Address Of Opposing Counsel: Telephone Number Trial date: Opposing Counsel email address: SECURED LEAVE FORM Rule 26 The General Rules of Practice for the Superior and District Courts STATEMENT OF ATTORNEY: I hereby certify that the secured leave period designated below is not being designated for the purpose of delaying, hindering or interfering with the timely disposition of any matter in any pending action or proceeding. I further certify that no action or proceeding in which I have entered an appearance has been scheduled, peremptorily set or noticed for trial, hearing, deposition or other proceeding during the designated leave period. Designated Leave Beginning Date: Designated Leave Ending Date: Designated Leave Beginning Date: Designated Leave Ending Date: Designated Leave Beginning Date: Designated Leave Ending Date: Calendar Year: 2009 2010 Calendar Year: 2009 2010 Calendar Year: 2009 2010 There are no other secure leave periods that have been previously designated by the undersigned for this calendar year. I have indicated all previously designated Secure Leave periods during the current calendar year that have been previously designated pursuant to Rule 26 below: Designated Leave Beginning Date: Designated Leave Ending Date: Designated Leave Beginning Date: Designated Leave Ending Date: CERTIFICATE OF SERVICE: I hereby certify that a copy of the foregoing Designation of Secured Leave has been served by regular US Mail, postage prepaid, upon the following parties/attorneys: (Counsel may attach additional Certificate of Service) Name and Address of Opposing Counsel or Party Telephone Number Calendar Year: 2009 2010 Calendar Year: 2009 2010 919-967-8989 Date Name Of Attorney Signature Of Attorney 15B Secured Leave 06/2009 Original-File Copy-Judicial Support Staff Copy-Plaintiff Copy-Defendant American LegalNet, Inc. www.FormsWorkFlow.com