Free Change of Address Form - Federal

UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT
CHANGE IN NAME/CONTACT INFORMATION Name, address, e-mail address, fax number, and phone number changes must be immediately reported to the Clerk's Office. You may fax this change of name/contact information form to (804) 916-2796. The fax number may be used only for that purpose. This form may be mailed to United States Court of Appeals, 1100 E. Main Street, Suite 501, Richmond, VA 23219-3517. Please identify all cases you have pending in this Court, along with the Fourth Circuit case number, District Court case number, and case name:

THE CLERK IS HEREBY NOTIFIED OF THE FOLLOWING CHANGE(S) (PLEASE PRINT OR TYPE LEGIBLY) DATE EFFECTIVE: CHANGE APPLIES TO: (attorney/party only) (entire firm) NEW INFORMATION Name: Firm Name: Address:

PREVIOUS INFORMATION Name: Firm Name: Address:

Phone #: Fax #: E-mail:

Phone #: Fax #: E-mail:

Date
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