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OKLAHOMA STATE BOARD OF EXAMINERS OF CERTIFIED SHORTHAND REPORTERS 2009 Annual Report of Compliance For Oklahoma Certified Shorthand Reporters MANDATORY CONTINUING EDUCATION REQUIREMENTS: All certified, licensed, or acting court reporters must complete a total of four (4) hours of continuing education per calendar year (CE hours must be earned by Dec 31). NOTICE: Rules regarding CSR Filing Deadlines are being revised in 2009. Your deadline for filing this form will be announced. Please pay attention to correspondence and email from the Administrative Office of the Courts regarding important information about your reporting deadlines and delinquent fees. If you have earned your CE hours, we encourage you to submit this report to the AOC before the end of the calendar year. Mail completed form to: The State Board of Examiners of Certified Shorthand Reporters Administrative Office of the Courts ATTN: CSR CE 1915 North Stiles, Suite 305 Oklahoma City, OK 73105

Name: Address:

City/State/Zip: Email: CSR #

Phone(s):

D.O.B.

Course Provider(s)

Course Title

Course Date

Hours

Report only courses

approved by the State Board of Examiners of Official CSR's

Total Hours

Note: The Administrative Office of the Courts is not a course provider. Therefore, questions about your attendance or about specific courses should be directed to the provider (e.g., OCRA, NCRA, etc.)

I, , the undersigned, hereby declare that I am not required by the provisions of 20 O.S. § 1503.1 to file an Annual Report of Compliance for calendar year 20 for the following reasons: (check one) 1). I was sixty-five (65) years of age or older in the year 20 . (Proof of age must be attached.) 2). I was a member of the armed forces on full-time active(Proofdo rimilitae y ntarte s eaustfb2 a ta hed). duty uf ng th r e s i u y m r o e0_t__c 3). I was medically unable to work or attend continuing education during the entire year of 20___. (Written verification by a licensed physician must be attached). -----------------------------------------------------------------------I, . the undersigned, do hereby swear and affirm that the above information is true and correct. I further understand that misrepresentation or falsification of any information contained herein may result in disciplinary action, including but not limited to suspension or revocation of my Oklahoma CSR/LSR license.

Claimant Signature

Date

State of Subscribed and sworn before me My Commission expires

,

County of , 20 , 20

Notary Public