HCN Judiciary Document Request Form (7/17)
O: /Public/Records Management
HO-CHUNK NATION JUDICIARY
Judicial Records Management
RECORDS REQUEST FORM
Date: ________________________________________________________________________________
Requester: ____________________________________________________________________________
Case Number/Case Name: _______________________________________________________________
Relationship to Case:______________________________________________
**Please be aware to request confidential documents, you must be a party to the case. **
See HO-CHUNK NATION CHILDREN AND FAMILY ACT, 4 HCC § 3.4; ELDER PROTECTION ACT OF 2001, 4
HCC § 1.7.c; WIS. STAT. § 51.30(4)(a); DHS 92.03
Department Name (if applicable): _________________________________________________________
Description of document(s): ______________________________________________________________
Regular copies are .10 cents per page, certified copies are .25 cents per page and court transcripts (CD
record) are $12.50 per CD. * Please note the scope of your request and/or the file size may limit our
response time. **Fees are subject to change.
*Payment must be received prior to fulfilling your request.
☐ A COPY # of copies _______ ☐ Need ASAP
☐ A CERTIFIED COPY # of copies ________ ☐ Need within 1 day
☐ A CD # of copies ________ ☐ Need within 2 or more days
☐ Email
☐ Will pick up
☐ Please mail to me (Cost of mailing will be at requester’s expense)
Contact Information of Requester
Address: _____________________________________________________________________________
Phone Number: ________________________________________________________________________
Signature of Requester
____________________________________________
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