Benton County Circuit Court
120 NW 4
PO Box 1870
Corvallis, Oregon 97339
Date request submitted: Benton County Case No:
Name of Requestor: _____________________ Telephone No: (______) __________________
Mailing Address: City: State: Zip:
Copies of the following documents:
Do you need certified copies? YES NO [If Yes, specify which documents must be certified.]
Pick up copies? YES N
O Send copies by USPS? YES NO
Copies are $ .25 per page plus $5.00 for each document that is certified OR
$10.00 for each exemplified copy.
Certified/exemplified documents will be full and correct copies of the original document on record in the Court office.
Checks should be made payable to ‘State of Oregon’. Payment MUST be received in advance. If the number of
pages is unknown at the time of making the request, please prepare a check with ‘Not to exceed $_____, (i.e.
$10.00)’. We will fill in the amount and provide you with a receipt, along with your copies.
Your copy[ies] will be available usually within a week. Requests for documents from cases older than
10 years may require additional time.
COPIES ARE NOT PICKED UP WITHIN 30 DAYS OF NOTIFICATION THEY WILL BE DISCARDED. WE
WILL NOT REIMBURSE FEES FOR COPIES NOT PICKED UP WITHIN 30 DAYS. YOU WILL HAVE TO
RESUBMIT YOUR REQUEST AND PAY THE REQUIRED FEES AGAIN!
[$ .25 per page]
Certified/Exemplified $ [$5.00/$10.00 in addition to per page copy fee]
FAX $ [$2.00 1
page/$1.00 each additional page]
Postage $ [$1.00 for 1-4 pages; $1.60 for 5-9 pages;
Additional pages at $ .25 extra for each 4
FOR OFFICIAL USE ONLY:
Room 101 104 106 Date Received: Date Notified:
Receipt No: ______ Cashier: ________