I
I
CERTIFIED TRANSCRIPTS / CERTIFICATES OF DISPOSITION
DATE OF BIRTH
NAME
STREET
ZIP
STATECITY
PHONE #
DATE OF VIOLATION
LAWS VIOLATED
DATE OF DISPOSITION
(NECESSARY IF A TRAFFIC CASE PRIOR TO JULY 1,1996)
REASON FOR TRANSCRIPT:
(e.g. License suspension, employment, any licensing or permits)
*********************************************************************
YOU MUST ATTACH A $5 MONEY ORDER, CERTIFIED CHECK OR ATTORNEY'S CHECK PAYABLE TO "FIRST DISTRICT
COURT'' FOR EACH DOCKET NUMBER. ALSO INCLUDE A SELF-ADDRESSED STAMPED ENVELOPE.
*** MAIL TO SUFFOLK DISTRICT COURT, ATTN: TRAFFIC/CRIMINAL ROOM 220 (TRANSCRIPTS)
TODAY'S DATE:
*** TRANSCRIPT REQUESTS ARE COMPLETED IN THE ORDER IN WHICH THEY ARE RECEIVED.
*** ALL REQUESTED INFORMATION MUST BE FILLED IN, OR YOUR REQUEST WILL BE RETURNED.
*** SHOULD YOU NEED ANY ADDITIONAL INFORMATION, CONTACT CENTRAL RECORDS IN YAPHANK FOR YOUR
ARREST RECORD (631) 852-6015.
IF YOU WERE A YOUTHFUL OFFENDER OR YOUR CASE WAS SEALED, ADDITIONAL PROCEDURES MUST
BE FOLLOWED :
IF YOU WERE ADJUDICATED AS A YOUTHFUL OFFENDER, PLEASE SIGN FORM #1 BEFORE A NOTARY PUBLIC AND
RETURN IT ALONG WITH THE FEE AND A SELF-ADDRESSED STAMPED ENVELOPE.
IF YOUR CASE WAS SEALED PURSUANT TO CPL 160.50 AND YOU WANT THE TRANSCRIPT SENT TO YOU, COMPLETE
FORM #2.
IF YOU WANT IT SENT TO SOMEONE ELSE, COMPLETE FORM #3.
IN ANY CASE, THE FORMS MUST BE RETURNED ALONG WITH THE FEE AND A SELF-ADDRESSED STAMPED ENVELOPE.
DC-411 (12/07)
STATE OF NEW YORK UNIFIED COURT SYSTEM
SUFFOLK COUNTY DISTRICT COURT
400 Carleton Avenue - Central Islip - New York 11722
nycourts.gov/suffolkdistrict
(631) 853-7500
DOCKET NUMBER
400 CARLETON AVENUE, CENTRAL ISLIP NY 11722
