Madera Superior C ourt Form Adopted for Optional Use MAD - JUV - 00 01 (Rev. 3/1 9 /19) REQUEST FOR RECORD SEARCH 226 JUVENILE DIVISION Page 1 of 1 SUPERIOR COURT OF CALIFORNIA 225 COUNTY OF MADERA Juvenile Department 200 South G Street Madera, CA 93637 PH: (559) 416-5580 FAX: (559) 673-0542 Hon., Dale J. Blea - Presiding Judge Bonnie Thomas - Court Executive Officer/Jury Commissioner Hon. Michael J. Jurkovich - Asst. Presiding Judge Amy Downey - Asst. Court Executive Officer REQUEST FOR RECORDS SEARCH 226 JUVENILE DIVISION BE ADVISED: Photo Identification is REQUIRED on ALL Juvenile record searches. FEES: $15.00 Search Fee: To search records or files, for each search longer than 10 minutes. $0.50 Copy Fee: Fee is per side, will be charged for each copy requested. $25.00 Certified Copy Fee: Will be charged for each certified copy requested 1. Purpose of Request: 2. Records to be searched: Juvenile Dependent Juvenile Delinquency Adoption Education Code Civil, Family Law Criminal 3. Search Information: Indicate year(s) to be searched: Court Case(s)#: Date of Violation(s): Name(s)/A.K.A.222s: Date of Birth(s): Violation(s): Additional Information: 4. Requesting Parties Information: Name: Contact Number: Date: Signature Note: 1) If case number(s) are provided, the request may be processed at the time of submission. 2) If case number(s) are not provided, your request will take two (2) weeks to process. 3) Please contact this office after the two (2) week period regarding the results of the record search. American LegalNet, Inc. www.FormsWorkFlow.com