distinguishing “good cause” 14 showing for sealing documents produced in discovery from “compelling reasons” 15 standard when merits-related documents are part of court record
How later courts described this case
- distinguishing “good cause” 14 showing for sealing documents produced in discovery from “compelling reasons” 15 standard when merits-related documents are part of court record
- even 12 stipulated protective orders require good cause showing
Written by the judges who cited it.
The opinion
1 Matthew C. Wolf (SBN 223051)
mwolf@thwvlaw.com
2 Lauren K. VanDenburg (SBN 299957)
lvandenburg@thwvlaw.com
3 Arya Shriani (SBN 350328)
ashirani@thwvlaw.com
4 TURNER HENNINGSEN WOLF & VANDENBURG, LLP
707 Wilshire Boulevard, Suite 3700
5 Los Angeles, California 90017
Tel: 323-653-3900
6 Attorneys for Defendant,
FCA US LLC
7
8 Tionna Carvalho (SBN 299010)
Email: tcarvalho@slpattorney.com
9 emailservices@slpattorney.com
Elizabeth A. LaRocque (SBN 219977)
10 Email: elaroque@slpattorney.com
Strategic Legal Practices, APC
11 1888 Century Park East, Floor 19
Los Angeles, CA 90067
12 Telephone: (310) 929-4900
Facsimile: (310) 943-3838
13 Attorneys for Plaintiff,
ARTHUR H BROUGHTON
14
15
UNITED STATES DISTRICT COURT
16
CENTRAL DISTRICT OF CALIFORNIA
17
ARTHUR H BROUGHTON, Case No. 5:24-cv-02510-JGB-SP
18 District Judge: Hon. Jesus G. Bernal
Plaintiff, Magistrate Judge: Sheri Pym
19
vs.
JOINT STIPULATED PROTECTIVE
20
FCA US LLC; and DOES 1 through 10, ORDER
21 inclusive.
22 Defendants.
23
24
25 1. PURPOSES AND LIMITATIONS
26 Discovery in this action is likely to involve production of confidential,
27 proprietary or private information for which special protection from public
1 warranted. Accordingly, the parties hereby stipulate to and petition the Court to
2 enter the following Stipulated Protective Order. The parties acknowledge that this
3 Order does not confer blanket protections on all disclosures or responses to
4 discovery and that the protection it affords from public disclosure and use extends
5 only to the limited information or items that are entitled to confidential treatment
6 under the applicable legal principles.
7
8 2. GOOD CAUSE STATEMENT
9 Documents and materials covered under the protective order contain
10 proprietary, financial, confidential, copyrighted, and sensitive information not
11 intended to be circulated among the general public. This includes copyrighted
12 vehicle information intended for purchase or to be used under license, sensitive
13 personally identifiable information, confidential business practices, and information
14 otherwise generally unavailable to the public. In many instances, redaction is not
15 possible as necessary information would be redacted, and in some instances more
16 information would be redacted than visible.
17 Special protection from public disclosure and from use for any purpose other
18 than prosecution of this action is warranted.
19 Accordingly, to expedite the flow of information, to facilitate the prompt
20 resolution of disputes over confidentiality of discovery materials, to adequately
21 protect information the parties are entitled to keep confidential, to ensure that the
22 parties are permitted reasonable necessary uses of such material in preparation for
23 and in the conduct of trial, to address their handling at the end of the litigation, and
24 serve the ends of justice, a protective order for such information is justified in this
25 matter. It is the intent of the parties that information will not be designated as
26 confidential for tactical reasons and that nothing be so designated without a good
27 faith belief that it has been maintained in a confidential, non-public manner, and
1 3. ACKNOWLEDGMENT OF UNDER SEAL FILING PROCEDURE
2 The parties further acknowledge, as set forth in Section 14.3, below, that this
3 Stipulated Protective Order does not entitle them to file confidential information
4 under seal; Local Civil Rule 79-5 sets forth the procedures that must be followed
5 and the standards that will be applied when a party seeks permission from the court
6 to file material under seal. There is a strong presumption that the public has a right
7 of access to judicial proceedings and records in civil cases. In connection with non-
8 dispositive motions, good cause must be shown to support a filing under seal. See
9 Kamakana v. City and County of Honolulu, 447 F.3d 1172, 1176 (9th Cir. 2006),
10 Phillips v. Gen. Motors Corp., 307 F.3d 1206, 1210-11 (9th Cir. 2002), Makar-
11 Welbon v. Sony Electrics, Inc., 187 F.R.D. 576, 577 (E.D. Wis. 1999) (even
12 stipulated protective orders require good cause showing), and a specific showing of
13 good cause or compelling reasons with proper evidentiary support and legal
14 justification, must be made with respect to Protected Material that a party seeks to
15 file under seal. The parties’ mere designation of Disclosure or Discovery Material as
16 CONFIDENTIAL does not— without the submission of competent evidence by
17 declaration, establishing that the material sought to be filed under seal qualifies as
18 confidential, privileged, or otherwise protectable—constitute good cause.
19 Further, if a party requests sealing related to a dispositive motion or trial, then
20 compelling reasons, not only good cause, for the sealing must be shown, and the
21 relief sought shall be narrowly tailored to serve the specific interest to be protected.
22 See Pintos v. Pacific Creditors Ass’n., 605 F.3d 665, 677-79 (9th Cir. 2010). For
23 each item or type of information, document, or thing sought to
24 be filed or introduced under seal, the party seeking protection must articulate
25 compelling reasons, supported by specific facts and legal justification, for the
26 requested sealing order. Again, competent evidence supporting the application to
27 file documents under seal must be provided by declaration.
1 Any document that is not confidential, privileged, or otherwise protectable in
2 its entirety will not be filed under seal if the confidential portions can be redacted. If
3 documents can be redacted, then a redacted version for public viewing, omitting
4 only the confidential, privileged, or otherwise protectable portions of the document,
5 shall be filed. Any application that seeks to file documents under seal in their
6 entirety should include an explanation of why redaction is not feasible.
7
8 4. DEFINITIONS
9 4.1 Action: this pending federal lawsuit.
10 4.2 Challenging Party: a Party or Non-Party that challenges the designation of
11 information or items under this Order.
12 4.3 “CONFIDENTIAL” Information or Items: information (regardless of how
13 it is generated, stored or maintained) or tangible things that qualify for protection
14 under Federal Rule of Civil Procedure 26(c), and as specified above in the Good
15 Cause Statement.
16 4.4 Counsel: Outside Counsel of Record and House Counsel (as well as their
17 support staff).
18 4.5 Designating Party: a Party or Non-Party that designates information or
19 items that it produces in disclosures or in responses to discovery as
20 “CONFIDENTIAL.”
21 4.6 Disclosure or Discovery Material: all items or information, regardless of
22 the medium or manner in which it is generated, stored, or maintained (including,
23 among other things, testimony, transcripts, and tangible things), that are produced or
24 generated in disclosures or responses to discovery.
25 4.7 Expert: a person with specialized knowledge or experience in a matter
26 pertinent to the litigation who has been retained by a Party or its counsel to serve as
27 an expert witness or as a consultant in this Action.
1 4.8 House Counsel: attorneys who are employees of a party to this Action.
2 House Counsel does not include Outside Counsel of Record or any other outside
3 counsel.
4 4.9 Non-Party: any natural person, partnership, corporation, association or
5 other legal entity not named as a Party to this action.
6 4.10 Outside Counsel of Record: attorneys who are not employees of a party to
7 this Action but are retained to represent a party to this Action and have appeared in
8 this Action on behalf of that party or are affiliated with a law firm that has appeared
9 on behalf of that party, and includes support staff.
10 4.11 Party: any party to this Action, including all of its officers, directors,
11 employees, consultants, retained experts, and Outside Counsel of Record (and their
12 support staffs).
13 4.12 Producing Party: a Party or Non-Party that produces Disclosure or
14 Discovery Material in this Action.
15 4.13 Professional Vendors: persons or entities that provide litigation support
16 services (e.g., photocopying, videotaping, translating, preparing exhibits or
17 demonstrations, and organizing, storing, or retrieving data in any form or medium)
18 and their employees and subcontractors.
19 4.14 Protected Material: any Disclosure or Discovery Material that is
20 designated as “CONFIDENTIAL.”
21 4.15 Receiving Party: a Party that receives Disclosure or Discovery Material
22 from a Producing Party.
23
24 5. SCOPE
25 The protections conferred by this Stipulation and Order cover not only
26 Protected Material (as defined above), but also (1) any information copied or
27 extracted from Protected Material; (2) all copies, excerpts, summaries, or
1 compilations of Protected Material; and (3) any testimony, conversations, or
2 presentations by Parties or their Counsel that might reveal Protected Material.
3 Any use of Protected Material at trial shall be governed by the orders of the trial
4 judge and other applicable authorities. This Order does not govern the use of
5 Protected Material at trial.
6
7 6. DURATION
8 Once a case proceeds to trial, information that was designated as
9 CONFIDENTIAL or maintained pursuant to this protective order used or introduced
10 as an exhibit at trial becomes public and will be presumptively available to all
11 members of the public, including the press, unless compelling reasons supported by
12 specific factual findings to proceed otherwise are made to the trial judge in advance
13 of the trial. See Kamakana, 447 F.3d at 1180-81 (distinguishing “good cause”
14 showing for sealing documents produced in discovery from “compelling reasons”
15 standard when merits-related documents are part of court record). Accordingly, the
16 terms of this protective order do not extend beyond the commencement of the trial.
17
18 7. DESIGNATING PROTECTED MATERIAL
19 7.1 Exercise of Restraint and Care in Designating Material for Protection. Each
20 Party or Non-Party that designates information or items for protection under this
21 Order must take care to limit any such designation to specific material that qualifies
22 under the appropriate standards. The Designating Party must designate for
23 protection only those parts of material, documents, items or oral or written
24 communications that qualify so that other portions of the material, documents, items
25 or communications for which protection is not warranted are not swept unjustifiably
26 within the ambit of this Order.
27 Mass, indiscriminate or routinized designations are prohibited. Designations
1 purpose (e.g., to unnecessarily encumber the case development process or to impose
2 unnecessary expenses and burdens on other parties) may expose the Designating
3 Party to sanctions.
4 If it comes to a Designating Party’s attention that information or items that it
5 designated for protection do not qualify for protection, that Designating Party must
6 promptly notify all other Parties that it is withdrawing the inapplicable designation.
7 7.2 Manner and Timing of Designations. Except as otherwise provided in this
8 Order, or as otherwise stipulated or ordered, Disclosure of Discovery Material that
9 qualifies for protection under this Order must be clearly so designated before the
10 material is disclosed or produced.
11 Designation in conformity with this Order requires:
12 (a) for information in documentary form (e.g., paper or electronic documents,
13 but excluding transcripts of depositions or other pretrial or trial proceedings), that
14 the Producing Party affix at a minimum, the legend “CONFIDENTIAL” (hereinafter
15 “CONFIDENTIAL legend”), to each page that contains protected material. If only a
16 portion of the material on a page qualifies for protection, the Producing Party also
17 must clearly identify the protected portion(s) (e.g., by making appropriate markings
18 in the margins).
19 A Party or Non-Party that makes original documents available for inspection
20 need not designate them for protection until after the inspecting Party has indicated
21 which documents it would like copied and produced.
22 During the inspection and before the designation, all of the material made
23 available for inspection shall be deemed “CONFIDENTIAL.” After the inspecting
24 Party has identified the documents it wants copied and produced, the Producing
25 Party must determine which documents, or portions thereof, qualify for protection
26 under this Order. Then, before producing the specified documents, the Producing
27 Party must affix the “CONFIDENTIAL legend” to each page that contains Protected
1 Producing Party also must clearly identify the protected portion(s) (e.g., by making
2 appropriate markings in the margins).
3 (b) for testimony given in depositions that the Designating Party identifies the
4 Disclosure or Discovery Material on the record, before the close of the deposition all
5 protected testimony.
6 (c) for information produced in some form other than documentary and for any
7 other tangible items, that the Producing Party affix in a prominent place on the
8 exterior of the container or containers in which the information is stored the legend
9 “CONFIDENTIAL.” If only a portion or portions of the information warrants
10 protection, the Producing Party, to the extent practicable, shall identify the protected
11 portion(s).
12 7.3 Inadvertent Failures to Designate. If timely corrected, an inadvertent failure
13 to designate qualified information or items does not, standing alone, waive the
14 Designating Party’s right to secure protection under this Order for such material.
15 Upon timely correction of a designation, the Receiving Party must make reasonable
16 efforts to assure that the material is treated in accordance with the provisions of this
17 Order.
18
19 8. CHALLENGING CONFIDENTIALITY DESIGNATIONS
20 8.1. Timing of Challenges. Any Party or Non-Party may challenge a
21 designation of confidentiality at any time that is consistent with the Court’s
22 Scheduling Order.
23 8.2 Meet and Confer. The Challenging Party shall initiate the dispute resolution
24 process under Local Rule 37-1 et seq.
25 8.3 Joint Stipulation. Any challenge submitted to the Court shall be via a joint
26 stipulation pursuant to Local Rule 37-2.
27 8.4 The burden of persuasion in any such challenge proceeding shall be on the
1 (e.g., to harass or impose unnecessary expenses and burdens on other parties) may
2 expose the Challenging Party to sanctions. Unless the Designating Party has waived
3 or withdrawn the confidentiality designation, all parties shall continue to afford the
4 material in question the level of protection to which it is entitled under the
5 Producing Party’s designation until the Court rules on the challenge.
6
7 9. ACCESS TO AND USE OF PROTECTED MATERIAL
8 9.1 Basic Principles. A Receiving Party may use Protected Material that is
9 disclosed or produced by another Party or by a Non-Party in connection with this
10 Action only for prosecuting, defending or attempting to settle this Action. Such
11 Protected Material may be disclosed only to the categories of persons and under the
12 conditions described in this Order. When the Action has been terminated, a
13 Receiving Party must comply with the provisions of section 15 below (FINAL
14 DISPOSITION).
15 Protected Material must be stored and maintained by a Receiving Party at a
16 location and in a secure manner that ensures that access is limited to the persons
17 authorized under this Order.
18 9.2 Disclosure of “CONFIDENTIAL” Information or Items. Unless otherwise
19 ordered by the court or permitted in writing by the Designating Party, a Receiving
20 Party may disclose any information or item designated “CONFIDENTIAL” only to:
21 (a) the Receiving Party’s Outside Counsel of Record in this Action, as well as
22 employees of said Outside Counsel of Record to whom it is reasonably necessary to
23 disclose the information for this Action;
24 (b) the officers, directors, and employees (including House Counsel) of the
25 Receiving Party to whom disclosure is reasonably necessary for this Action;
26 (c) Experts (as defined in this Order) of the Receiving Party to whom
27 disclosure is reasonably necessary for this Action and who have signed the
1 (d) the court and its personnel;
2 (e) court reporters and their staff;
3 (f) professional jury or trial consultants, mock jurors, and Professional Vendors
4 to whom disclosure is reasonably necessary for this Action and who have signed the
5 “Acknowledgment and Agreement to Be Bound” (Exhibit A);
6 (g) the author or recipient of a document containing the information or a
7 custodian or other person who otherwise possessed or knew the information;
8 (h) during their depositions, witnesses, and attorneys for witnesses, in the
9 Action to whom disclosure is reasonably necessary provided: (1) the deposing party
10 requests that the witness sign the form attached as Exhibit A hereto; and (2) they
11 will not be permitted to keep any confidential information unless they sign the
12 “Acknowledgment and Agreement to Be Bound” (Exhibit A), unless otherwise
13 agreed by the Designating Party or ordered by the court. Pages of transcribed
14 deposition testimony or exhibits to depositions that reveal Protected Material may
15 be separately bound by the court reporter and may not be disclosed to anyone except
16 as permitted under this Stipulated Protective Order; and (i) any mediators or
17 settlement officers and their supporting personnel, mutually agreed upon by any of
18 the parties engaged in settlement discussions.
19
20 10. PROTECTED MATERIAL SUBPOENAED OR ORDERED PRODUCED IN
21 OTHER LITIGATION
22 If a Party is served with a subpoena or a court order issued in other litigation
23 that compels disclosure of any information or items designated in this Action as
24 “CONFIDENTIAL,” that Party must:
25 (a) promptly notify in writing the Designating Party. Such notification shall
26 include a copy of the subpoena or court order;
27 (b) promptly notify in writing the party who caused the subpoena or order to
1 or order is subject to this Protective Order. Such notification shall include a copy of
2 this Stipulated Protective Order; and
3 (c) cooperate with respect to all reasonable procedures sought to be pursued by
4 the Designating Party whose Protected Material may be affected. If the Designating
5 Party timely seeks a protective order, the Party served with the subpoena or court
6 order shall not produce any information designated in this action as
7 “CONFIDENTIAL” before a determination by the court from which the subpoena
8 or order issued, unless the Party has obtained the Designating Party’s permission.
9 The Designating Party shall bear the burden and expense of seeking protection in
10 that court of its confidential material and nothing in these provisions should be
11 construed as authorizing or encouraging a Receiving Party in this Action to disobey
12 a lawful directive from another court.
13
14 11. A NON-PARTY’S PROTECTED MATERIAL SOUGHT TO BE PRODUCED
15 IN THIS LITIGATION
16 (a) The terms of this Order are applicable to information produced by a Non-
17 Party in this Action and designated as “CONFIDENTIAL.” Such information
18 produced by Non-Parties in connection with this litigation is protected by the
19 remedies and relief provided by this Order. Nothing in these provisions should be
20 construed as prohibiting a Non-Party from seeking additional protections.
21 (b) In the event that a Party is required, by a valid discovery request, to produce
22 a Non-Party’s confidential information in its possession, and the Party is subject to
23 an agreement with the Non-Party not to produce the Non-Party’s confidential
24 information, then the Party shall:
25 (1) promptly notify in writing the Requesting Party and the Non-Party that
26 some or all of the information requested is subject to a confidentiality agreement
27 with a Non-Party;
1 (2) promptly provide the Non-Party with a copy of the Stipulated Protective
2 Order in this Action, the relevant discovery request(s), and a reasonably specific
3 description of the information requested; and
4 (3) make the information requested available for inspection by the Non-Party,
5 if requested.
6 (c) If the Non-Party fails to seek a protective order from this court within 14
7 days of receiving the notice and accompanying information, the Receiving Party
8 may produce the Non-Party’s confidential information responsive to the discovery
9 request. If the Non-Party timely seeks a protective order, the Receiving Party shall
10 not produce any information in its possession or control that is subject to the
11 confidentiality agreement with the Non-Party before a determination by the court.
12 Absent a court order to the contrary, the Non-Party shall bear the burden and
13 expense of seeking protection in this court of its Protected Material.
14
15 12. UNAUTHORIZED DISCLOSURE OF PROTECTED MATERIAL
16 If a Receiving Party learns that, by inadvertence or otherwise, it has disclosed
17 Protected Material to any person or in any circumstance not authorized under this
18 Stipulated Protective Order, the Receiving Party must immediately (a) notify in
19 writing the Designating Party of the unauthorized disclosures, (b) use its best efforts
20 to retrieve all unauthorized copies of the Protected Material, (c) inform the person or
21 persons to whom unauthorized disclosures were made of all the terms of this Order,
22 and (d) request such person or persons to execute the “Acknowledgment an
23 Agreement to Be Bound” attached hereto as Exhibit A.
24
25 13. INADVERTENT PRODUCTION OF PRIVILEGED OR OTHERWISE
26 PROTECTED MATERIAL
27 When a Producing Party gives notice to Receiving Parties that certain
1 the obligations of the Receiving Parties are those set forth in Federal Rule of Civil\
2 Procedure 26(b)(5)(B). This provision is not intended to modify whatever procedure
3 may be established in an e-discovery order that provides for production without
4 prior privilege review. Pursuant to Federal Rule of Evidence 502(d) and (e), insofar
5 as the parties reach an agreement on the effect of disclosure of a communication or
6 information covered by the attorney-client privilege or work product protection, the
7 parties may incorporate their agreement in the stipulated protective order submitted
8 to the court.
9
10 14. MISCELLANEOUS
11 14.1 Right to Further Relief. Nothing in this Order abridges the right of any
12 person to seek its modification by the Court in the future.
13 14.2 Right to Assert Other Objections. By stipulating to the entry of this
14 Protective Order, no Party waives any right it otherwise would have to object to
15 disclosing or producing any information or item on any ground not addressed in this
16 Stipulated Protective Order. Similarly, no Party waives any right to object on any
17 ground to use in evidence of any of the material covered by this Protective Order.
18 14.3 Filing Protected Material. A Party that seeks to file under seal any
19 Protected Material must comply with Local Civil Rule 79-5. Protected Material may
20 only be filed under seal pursuant to a court order authorizing the sealing of the
21 specific Protected Material. If a Party’s request to file Protected Material under seal
22 is denied by the court, then the Receiving Party may file the information in the
23 public record unless otherwise instructed by the court.
24
25 15. FINAL DISPOSITION
26 After the final disposition of this Action, as defined in paragraph 6, within 60
27 days of a written request by the Designating Party, each Receiving Party must return
1 this subdivision, “all Protected Material” includes all copies, abstracts, compilations,
2 summaries, and any other format reproducing or capturing any of the Protected
3 Material. Whether the Protected Material is returned or destroyed, the Receiving
4 Party must submit a written certification to the Producing Party (and, if not the same
5 person or entity, to the Designating Party) by the 60-day deadline that (1) identifies
6 (by category, where appropriate) all the Protected Material that was returned or
7 destroyed and (2) affirms that the Receiving Party has not retained any copies,
8 abstracts, compilations, summaries or any other format reproducing or capturing any
9 of the Protected Material. Notwithstanding this provision, Counsel are entitled to
10 retain an archival copy of all pleadings, motion papers, trial, deposition, and hearing
11 transcripts, legal memoranda, correspondence, deposition and trial exhibits, expert
12 reports, attorney work product, and consultant and expert work product, even if such
13 materials contain Protected Material. Any such archival copies that contain or
14 constitute Protected Material remain subject to this Protective Order as set forth in
15 Section 6 (DURATION).
16
17 16. VIOLATION
18 Any violation of this Order may be punished by appropriate measures
19 including, without limitation, contempt proceedings and/or monetary sanctions.
20 ///
21 ///
22 ///
23 ///
24 ///
25 ///
26 ///
27 ///
1 IT IS SO STIPULATED, THROUGH COUNSEL OF RECORD.
2
3 Dated: May 16, 2025 /s/ Elizabeth A. LaRocque
4 Attorneys for Plaintiff
5 ARTHUR H. BROUGHTON
6
7 Dated: May 16, 2025 /s/ Matthew C. Wolf
8 Attorneys for Defendant
9 FCA US, LLC
10
11 Pursuant to Civil Local Rule 5-4.3.4(a)(2), I hereby attest that all signatories listed,
12 and on whose behalf the filing is submitted, concur in the filing’s content and have
13 authorized the filing.
14
15 Dated: May 16, 2025 /s/ Matthew C. Wolf
16 Attorneys for Defendant
17 FCA US, LLC
18
19 FOR GOOD CAUSE SHOWN, IT IS SO ORDERED.
20
21 Dated: May 23, 2025 ___________________________________
22 HON. SHERI PYM
23 United States Magistrate Judge
24
25
26
27
1 EXHIBIT A
2 CERTIFICATION RE CONFIDENTIAL DISCOVERY MATERIALS
I hereby acknowledged that I, ______________________________ [NAME],
3
____________________________________________ [POSITION AND EMPLOYER], am
4
about to receive Confidential Materials supplied in connection with the proceeding, Arthur H
5
Broughton v. FCA US, LLC (5:24-cv-02510-JGB-SP). I certify that I understand the Confidential
6 Materials are provided to me subject to the terms and restrictions of the Stipulation and Protective
7 Order filed in this Proceeding. I have been given a copy of this Stipulation and Protective Order; I
8 have read it, and I agree to be bound by its terms.
I understand that Confidential Materials, as defined in the Stipulation and Protective Order,
9
including any notes or other records that may be made regarding any such materials, shall not be
10
Disclosed to anyone except as expressly permitted by the Stipulation and Protective Order. I will
11
not copy or use, except solely for the purposes of this Proceeding, any Confidential Materials
12
obtained pursuant to this Protective Order, except as provided therein or otherwise ordered by the
13 Court in the Proceeding.
14 I further understand that I am to retain all copies of all Confidential Materials provided to
15 me in the Proceeding in a secure manner and that all copies of such Materials are to remain in my
personal custody until termination of my participation in the Proceeding, whereupon the copies of
16
such Materials will be returned to counsel who provided me with such Materials.
17
I declare under penalty of perjury, under the laws of the State of California, that the
18
foregoing is true and correct. Executed this_____ day of _____, 20_____, at _________________.
19
20 DATED: _________________________ BY: ______________________________
21 Signature
______________________________
22
Title
23
______________________________
24
Address
25 ______________________________
26 City, State, Zip
27 ______________________________
Telephone Number