Madera Superior Court Form Adopted for Optional Use MAD - CIV - 000 4 ( Rev 3 / 06 / 19 ) REQUEST FOR RECORD SEARCH Page 1 of 1 SUPERIOR COURT OF CALIFORNIA 225 COUNTY OF MADERA Civil Department 200 South G Street Madera, CA 93637 PH: (559) 416-5525 FAX: (559) 675-6565 Hon., Dale Blea - Presiding Judge Hon. Michael J. Jurkovich - Asst. Presiding Judge Bonnie Thomas - Court Executive Officer/Jury Commissioner Amy Downey - Asst. Court Executive Officer Darla Lamb - Supervisor REQUEST FOR RECORDS SEARCH 226 CIVIL DIVISION FEES: $15.00 search fee per name is required at the time your request is submitted. $.50 fee will be charged for each copy requested. $25.00 fee will be charged for each certified copy requested in addition to the copy fee. $15.00 fee will be charged for each certified copy of Dissolution Judgment. Self-addressed stamped envelope is also required to mail your copies to you. Cash, check or money order is required with your request. PURPOSE OF REQUEST: RECORDS TO BE SEARCHED: Probate Civil Family Law Small Claims Please indicate the year(s) you wish searched: Case # Name(s) Date of Birth: Court Name/Number: Other Information: NOTE: 1) If you provide the case number(s), your request may be processed at the time of submission. 2) If you do not provide the case number(s), your request will take up to three (3) weeks to process. You may contact this office after one week regarding the results of the record(s) search. DATE: SIGNATURE Requestor222s Name Address Phone Number American LegalNet, Inc. www.FormsWorkFlow.com