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Here is the text we could read:

Approved, SCAO

Court name and address

REQUEST FOR REASONABLE
ACCOMMODATIONS AND RESPONSE

Telephone number of ADA coordinator:

You should request accommodations as far as possible in advance of your court appearance or other court activity. To request
accommodations, complete and return this form to the court at the above address. If you need help completing this form, contact
the ADA coordinator at the above telephone number. To properly evaluate your request, the court may ask you for more information.

The ADA coordinator will respond to your request before the court appearance or other court activity. If your request is denied, you
may request a review in accordance with the court's local administrative order. At your request, the court will provide you a copy of
the local administrative order.

Today's date

Name

Address

City

APPLICANT INFORMATION (to be kept confidential)

Applicant is

Witness

Juror

Attorney

Party

Other (specify)

Case name and number (if applicable)

E-mail address

State

Zip

Telephone no.

1. What type of proceeding or court service, activity, or program are you attending (i.e., hearing, jury duty, mediation meeting, trial)?

3. For what impairment do you need accommodations (for a sign language interpreter, specify ASL, CDI, or CART)?

2. On what dates do you need accommodations?

4. What type of accommodations do you need?

RESPONSE TO REQUEST

The request is GRANTED

for the above matter or appearance,

from

in whole as follows: (specify the accommodations)

for an indefinite period,

in part. As consented to by the applicant, alternative accommodations are as follows: (specify the accommodations)

The request is DENIED because

the applicant is not a qualified individual with a disability under the ADA.
the request creates an undue financial or administrative burden on the court (as defined by the ADA).
the request fundamentally alters the nature of the service, program, or activity (as defined by the ADA).

The basis for this denial is: (Specify on separate sheet if needed. Include alternative accommodations offered but rejected by the applicant.)

The applicant was notified of the court's response

by phone

by mail

by e-mail

in person

Date

Name

MC 70 (10/15) REQUEST FOR REASONABLE ACCOMMODATIONS AND RESPONSE

MCL 393.501 et seq., 42 USC 12111 et seq.

Request for Reasonable Accommodations and Response

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/general-use (2023-03)
Page(s): 1
Fields(s): 41
Average fields per page: 41
Reading Level: Grade 10
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

court_address_ad was Court name and address Telephone number of ADA coordinator (0.65 conf)
todays_date was Todays date (0.37 conf)
witness was Witness (0.46 conf)
juror was Juror (0.45 conf)
attorney was Attorney (0.45 conf)
party was Party (0.32 conf)
specify was Other specify (0.37 conf)
case_name_number_applicable was Case name and number if applicable (0.36 conf)
users1_name was Name (1.00 conf)
users1_email was Email address (1.00 conf)
users1_address_line_one was Address (1.00 conf)
telephone was Telephone no (0.44 conf)
to was to (0.43 conf)
undefined__1 was undefined (0.38 conf)
request_granted was The request is GRANTED (0.36 conf)
request_denie was The request is DENIED because (0.34 conf)
matter_appearance was for the above matter or appearance (0.38 conf)
from was from (0.41 conf)
indefinite_period was for an indefinite period (0.33 conf)
whole_follows_specify was in whole as follows specify the accommodations (0.33 conf)
applicant_follows_specify was in part As consented to by the applicant alternative accommodations are as follows specify the accommodations (0.46 conf)
applicant_individual_disability was the applicant is not a qualified individual with a disability under the ADA (0.40 conf)
undue_financial_burden was the request creates an undue financial or administrative burden on the court as defined by the ADA (0.45 conf)
fundamentally_program_activity was the request fundamentally alters the nature of the service program or activity as defined by the ADA (0.38 conf)
phone was by phone (0.38 conf)
mail was by mail (0.48 conf)
email was by email (0.48 conf)
person was in person (0.38 conf)
by was by (0.38 conf)
undefined__2 was undefined_2 (0.39 conf)
text__1 was Text4 (0.35 conf)
text__2 was Text5 (0.35 conf)
text__3 was Text6 (0.35 conf)
text__4 was Text7 (0.35 conf)
text__5 was Text8 (0.35 conf)
text__6 was Text9 (0.35 conf)
text__7 was Text10 (0.35 conf)
text__8 was Text11 (0.35 conf)
text__9 was Text12 (0.35 conf)
text__10 was Text13 (0.35 conf)
ada_telephone was ADATelephone no (0.51 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Request for Reasonable Accommodations and Response

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02