Petition In Error Page 4

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IX. NAME OF COUNSEL OR PARTY, IF PRO SE
ATTORNEY FOR APPELLANT
Name:
OBA No.:
Firm:
Designated Case-Specific Email Address: [if applicable]
Secondary Email Address: [if applicable]
Address:
Telephone:
ATTORNEY FOR APPELLEE
Name:
OBA No.:
Firm:
Designated Case-Specific Email Address: [if applicable]
Secondary Email Address: [if applicable]
Address:
Telephone:
DATE: ______________________ 20___
Verified by (Signature of Attorney or Pro Se Party)
Firm
Designated Case-Specific Email Address [if
applicable]
Secondary Email Address [if applicable]
Address
Telephone

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