STIPULATION FOR DISMISSAL IN THE DISTRICT COURT OF THE THIRD CIRCUIT ______________________________ DIVISION STATE OF HAWAI`I
Plaintiff(s)
Form #3DC21
Reserved for Court Use
Civil No. Defendant(s) Filing Party(ies)/Filing Party(ies)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Facsimile Numbers)
Court Date & Time:
G Return G None
G Pre-Trial G Disposition/Other
G Trial
STIPULATION FOR DISMISSAL Plaintiff(s) and Defendant(s) Stipulate for the Entry of Dismissal in the above-entitled case (select one) G WITH G WITHOUT prejudice pursuant to District Court Rules of Civil Procedure, Rule 41(a)(1)(ii). This Stipulation for Dismissal is being signed by all parties who have appeared in this action. (select one)
G Partial Dismissal as to Defendant(s)
(Certificate of Service required on other Defendant(s))
.
G By signing this document, I/we acknowledge that there are no remaining claims or parties.
Signature of Plaintiff(s)/Plaintiff(s)' Attorney: Date: Print/Type Name: Signature of Plaintiff(s)/Plantiff(s)' Attorney: Date: Print/Type Name: Signature of Defendant(s)/Defendant(s)' Attorney: Date: Print/Type Name: Signature of Defendant(s)/Defendant(s)' Attorney: Date: Print/Type Name:
In accordance with the Americans with Disabilities Act if you require an accommodation for your disability, please contact the ADA Coordinator at PHONE NO. 934-5788, FAX 935-1959, or TTY 961-7525 at least ten (10) working days in advance of your hearing or appointment date.
DISMSTIP.X (Amended 4/18/97)v
3D-P-272
Clear form
Reprographics (11/06)