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OF DEFENDANT: STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: DATE OF COURT ORDER: (check one) Short Title: Docket No. PROOF OF ENROLLMENT IN ALCOHOL OR DRUGNOTICE OF APPEARANCE PROGRAM CASE NUMBER: Appearance for (provide name of party): PROOF OF COMPLETION OF ALCOHOL OR DRUG PROGRAM Status of Party: ( ) Appellant/Petitioner ( ) Appellee/Respondent DESCRIPTION OF ALCOHOL ( ) Cross-Appellant/Cross-Petitioner Name of Program: ( ) Other (Specify): Address of An attorney will argue this a.

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