Madera Superior Court Form Adopted for Optional Use MAD - TRC - 00 01 (Rev. 3 / 1 9 /19) REQUEST FOR RECORD SEARCH 226 TRAFFIC DIVISION Page 1 of 1 SUPERIOR COURT OF CALIFORNIA COUNTY OF MADERA 200 South G Street, Madera CA 93637 (559)416-5555 Joseph A. Soldani 226 Presiding Judge Dale J. Blea 226 Asst. Presiding Judge Bonnie Thomas 226 Chief Executive Officer Melissa Taylor 226 Traffic Division Supervisor REQUEST FOR RECORDS SEARCH-TRAFFIC DIVISION FEES: A $15.00 fee for the search is required at the time your request is submitted. A $.50 fee will be charged for each copy requested. A $25.00 fee will be charged for each certified copy requested. PURPOSE OF REQUEST: RECORDS TO BE SEARCHED: Criminal Traffic Other: Please indicate the year(s) you wish searched: Case # Date of Violation Name(s) Date of Birth: Court Name/Number: Violation(s): 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