RANDOLPH COUNTY COURTHOUSE FACILITY
APPLICATION FOR COUNTY ISSUED IDENTIFICATION
ATTORNEY’S PARALEGAL OR SECRETARY
NAME OF APPLICANT ____________________________________________________________
LAST FIRST M.
DATE OF BIRTH __________________
COMPANY NAME _________________________________ PHONE# _______________
BUSINESS ADDRESS _______________________________________________________
CERTIFICATE OF SPONSORING ATTORNEY
I certify the person above is a paralegal or secretary, and is employed in my organization, and meets the
criteria described below:
1) The applicant visits the courthouse for paralegal and secretarial business
on a frequent basis.
2) I will take full responsibility for any violations of Courthouse Policy.
3) What Day and Time Range will you need access into the courthouse?
________________________________________________________
________________________________________________________
I understand I must retrieve the I.D. badge and turn this into the County Security Office when the
person’s is no longer a paralegal or secretary in my organization.
Print Name of Sponsoring Attorney _________________________________
Signature of Sponsoring Attorney ___________________________________
____________________________________________________________________________________
Requirement at Time of Application
1) Completed Application
I understand this I.D. badge cannot be loaned to another individual. I will not allow a person without a
badge to accompany me through the card swipe entrances or carry unauthorized items into the courthouse.
I further understand it is my duty to secure this badge, and agree to contact Security immediately at 318-
6774 if lost or stolen. I understand this is a privilege, which can be rescinded in the sound discretion of
issuing authority.
Signature of Applicant Date
COST: 1. $15.00 PER CARD (INITIAL CARD)
2. $25.00 FEE FOR DUPLICATE CARD IF LOST OR STOLEN.
