LOS ANGELES SMALL CLAIMS PUBLIC HEARING INDICATION OF INTEREST The hearing room in Los Angeles has a limited numbers of seats for participants and observers. Therefore, each participating entity may designate only one individual to represent it on a particular hearing panel, although the entity may designate a different individual for each different panel the entity requests to attend. The Office will attempt to accommodate preferences to the greatest extent possible while allowing for a maximum number of viewpoints. If interested in participating in one or more hearing panels, please provide the information requested in the below form. If more than one individual seeks to participate on behalf of a particular entity, each such individual should complete and submit a participation form. Forms should be submitted electronically through this website no later than November 21, 2012 by filling out the below information and clicking on the “submit” button. If an individual is unable to submit the form electronically, please contact Catherine Rowland at [email protected] for instructions. Note: Use this form only to indicate that you wish to participate in a hearing. For observation without participation, the Office will provide public seating on a first come, first serve basis on the day of the hearing(s). Because space is limited and to allow for a diverse audience, we ask that entities limit observers to one per panel.

	Participant Information
Name:   Title:   Organization: (if applicable)       Street Address:   Address Line 2:   City:   State: Select Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas (except Canada) Armed Forces Africa, Canada, Europe, Middle East Armed Forces Pacific Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Micronesia Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virgina Wisconsin Wyoming Other   ZIP or postal code:   Phone:   Email address:         If another individual from the same entity also wishes to participate, please provide that person's name (each individual seeking to participate needs to submit a separate form).     Rank the panels by order of your level of interest, with 1 being the panel you are most interested in. If there is a panel that you are not interested in, leave the space next to that panel blank.     Interest Level   Panel I: Forum, jurisdiction, and decisionmakers   Panel II: Subject matter, claims, and defenses   Panel III: Practice and procedure   Panel IV: Litigation alternatives   Panel V: Relief and appeals   Panel VI: Constitutional issues   Panel VII: Moving forward         Provide a brief explanation as to why you wish to participate in the public hearings, including, if you would like, why you are interested in specific panels.     If you would like to discuss a topic that is not set forth in the August 23, 2012 Notice of Inquiry during Panel VII as an “Other Issue,” please identify the issue and provide a brief explanation.
Clicking "submit" will file your request with the U.S. Copyright Office. The next screen will display a printable page showing the complete information you entered. You will also receive an email copy of your request.