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2. Requestor Information
4. Requestor Name - Last, First, Middle*
5. Phone Number*
7. Requestor's Address - Street, City, State, Zip Code*
9. Requestor's Email Address
13. Please insert as much information as possible. Failure to include as much identifying information will delay our ability to complete requests.
15. Case No.
16. Date of Birth
17. Driver's License Number
19. Defendant - Last, First, Middle
21. Defendant Address - Street, City, State, Zip Code
25. Documents Requested:

    1. Defendant's Criminal History
    2. Complaint/Citation
    3. Conviction Documents (i.e. Judgment and Sentence, Plea Form)
    4. Docket
27. Other documents - please be specific
29. Do you need the document you are requesting to be certified?

    Please be advised that there is a cost of $5.00 for the first page and $1.00 for each additional page.

    1. Yes
    2. No
31. Request a copy of a recording of a court proceeding:
    Compact Disk (CD) FTR Gold format can only be played on a computer with at least Windows XP operating system (or newer) and the FTR Play er ( http://www.fortherecord.com/products/player/ ). Cost is $20.00 per CD.
33. Date of Court Proceeding
34. Time of Court Proceeding
35. Case No.
37. Signature
38. Request Date
40. NOTICE
    You will be notified when your records are ready. If there is a cost associated with your request, you must remit payment within 96 hours (excluding weekends and holidays) of the notification that your records are ready.
44. To be Completed by Court Personnel
46. Completed by:
47. Date Completed
48. Cost
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field