MARTELL ASSOCIATES

 

Transcript Order Form

 

 

       Please fill out the following information and email or fax it to us and we will promptly get to work producing your requested transcript.

 

        Our Fax number is:  855-825-1721

 

        Our email is:  glenn@martellassociates.com

 

    

       DATE TAKEN: _________________________________________

 

 

       CASE NAME: _________________________________________

 

 

       WITNESS NAME: _________________________________________

 

 

      INSURANCE CARRIER (optional): _________________________________________

 

 

      CLAIM NUMBER  (optional): _________________________________________

 

     

      ORDERING PARTY CONTACT INFORMATION:

 

            NAME: _________________________________________

 

            LAW FIRM NAME:   _________________________________________

     

            PHONE NUMBER: _________________________________________ 

 

            EMAIL ADDRESS: _________________________________________  

 

 

   Note:  Once an order is placed, any cancellations must be received by Martell Associates within 24 hours of order placement to stop the production of the requested transcript. Signature below signifies acceptance of the above terms.

 

 

       _________________________________________

                   Print Name (ordering party)

 

 

       _________________________________________

                   Signature (ordering party)

 

 

       _________________________________________

                    Date of order