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Please print or type
Costs: All copies $1.00 per page
(There will be a 3-day processing time from day of request)
Requesting date: ____________________
Cause No.: _____________________________ ___________ Court: _ _______________
(If cause number is unknown, Provide file date, type of cause & a $5.00 Research fee)
Style _______________________ _________ VS. _ ______________________________________
Request copy of __________________________ Number of copies _________ Certified: YES or NO
(circle one)
Cust
omer’s (printed) Name:_____________
_______________________________________________
Phone Number: (_______) -___________________________________________________________
Address : _____________________________________________________________________
_____________________________________________________________________
Amount Paid: $_________
___(Cash or Law Firm check#)
For p
ick up/number to call when copy is ready: _____________________________
___
Or, Mail to:
_____________________________________________________________
(please attach a self -addressed stamped envelope)
For District Clerk’s use only
Court: _______________________ Total number of pages ________________
Volume: __________ page :_____________ Image date :__________________
Amount due at time of pick up _______ ____ Called for pick up ______________
Notes
Revised 10/04/2017
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Please print or type Costs: All copies $1.00

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Completed 2 June 2021

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