allahassee, FL 3230-1050 . Office: (800)2264687 Fax: (853) 414.6191 Bill Status Inform:tier for Providers 050) 414-3331 • TDD users may call through Florida Relay Service at 1.803.9558771 'Nebsite: myfloridalegalcom • Email address: [email protected] BUREAU OF VICTIM COMPENSATION CLAIM FORM Instructions P

allahassee, FL 3230-1050 . Office: (800)2264687 Fax: (853) 414.6191 Bill Status Inform:tier for Providers 050) 414-3331 • TDD users may call through Florida Relay Service at 1.803.9558771 'Nebsite: myfloridalegalcom • Email address: [email protected] BUREAU OF VICTIM COMPENSATION CLAIM FORM Instructions P

allahassee, FL 3230-1050 . Office: (800)2264687 Fax: (853) 414.6191 Bill Status Inform:tier for Providers 050) 414-3331 • TDD users may call through Florida Relay Service at 1.803.9558771 'Nebsite: myfloridalegalcom • Email address: [email protected] BUREAU OF VICTIM COMPENSATION CLAIM FORM Instructions P

0; (800) 955-8771 (TDD) or (800) 955-8770 (V) via Florida Relay Service If you are hearing or voice impaired, call 711.

he Court, 205 North Dixie Highway, Room 5 2500, West Palm Bench, FL 33401, telephone (561)355.2431, 1-800-955-R771 (IDD), or 1-800- 955-8770(V), via Florida Relay Service". THEODORE J. LEOPOLD, ESQUIRE RICO-LEOPOLD, P.A. 2925 PGA Boulevard Suite 200 Palm Beach Gardens, FL 33410 (561) 684-6500 THE STATE OF FLORID

ourt of Appeal, 1525 Palm Beach Lakes Blvd., West Palm Beach, Florida 33401, telephone (561)242-2000; 1-800-955-8771(TDD): or I- 800-955-8770(V) via Florida Relay Service, at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance

e Court, 205 North Dixie Highway, Room 5.2500, West Palm Beach, FL 33401, telephone (561)355-2431, 1-800-955-8771 (TDD), or 1-800-955-8770 (V), via Florida Relay Service". Dapre ako ki fa avek Americans With Disabilities Act, tout motor ld ginyin yun benven dspesiyal you akomodasiyon you yo patisipe nan pwogram sa-a

e Court, 205 North Dixie Highway, Room 5.2500, West Palm Beach, FL 33401, telephone (561)355-2431, 1-800-955-8771 (TDD), or 1-800-955-8770 (V), via Florida Relay Service". Dapre ako ki fa avek Americans With Disabilities Act, tout moun Id ginyin yun benven 6spesiyal you akomodasiyon you yo patisipe nan pwogram sa-a

nable time prior to any proceeding contact the Administrative Office of the Court 205 N. Dixie Hi hwa Room W P Im Beach, FL 33401, to ; or , via Florida Relay Service. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to all Parties on the attached Service L

hassee, FL 32399-1050 • Office! (800) 226-6657 Fax: (850) 414-6191 Bill Status Information for Providers 1850) 414-3331 • TOD users may call through Florida Relay Service at 1.803-955.8771 Website: myfloridategal.com • Email address: [email protected] BUREAU OF VICTIM COMPENSATION CLAIM FORM Instructions