Rev. //201 www.mncourts.gov/hennepin Hennepin County District Court Copy Request Form (Civil, Conciliation, Criminal, Family, Mental Health, Probate, & Traffic cases) ontact Juvenile Court to get copies of their case records. Send completed Request Form and payment to: Fourth Judicia l District Court Records Center Hennepin County Government Center 300 South Sixth Street, #B100 Minneapolis, MN 55487 - 0332 Questions? Call (612) 348 - 3170 Part A: Requesting Party Name (required) Phone Address (required for certified cop ies or mai l delivery ) Email (required for plain copies delivered via email) City / State / Zip Fax (required for plain copies delivered via fax) Part B: Case Information Party n ame(s) at the time the case was f iled Plaintiff / Petitioner Defendant / Respondent * * For c riminal records, you must include the court file number (below) . If you request a copy of a c onfidential record (e.g., paternity) , y ou must attach a copy of your phot o I.D. to this form to verify that you are a party in the case. We cannot email or fax confidential documents. Court File Number (if known) If you want a copy of a document from a case fil ed before 1970 the file n umber, fill in a 5 - year date range of whe n the case was probably fil ed. Date range f rom: t o: Par t C: Document (s) & Type of Copy $ for each plain copy $1 for each certified copy Check the box for the document ( s ) you want and fill in the number for each t ype of cop y . If yo u know the document title not listed here , please describe it below. Attach more page s if needed. * N ote : If you want a specific version of a document other than the most recent, please fill in the date the documen t was filed. Find filing dates at www.mncourts.gov/caserecords . Plain Copy ($) Certified Copy ($1) Date Filed * Example Order number of copies # 2 # 2 5/2/2014 (fees due = $($ + $) Divorce Decree # # C hild Support Order # # Visitation / Custody Order # # QD RO (Qualified Domestic Relations Order) # # Judg ment # # Name Change O rder # # Sum mons and C omplaint /P etition # # Summary Real Estate Judgment # # Plea P etition # # Conviction # # Real Estate Sales P ack age (Probate) # # Other / Comments : Pa rt D: Copy Fees & Delivery Options $ for each plain copy $1 for each certified copy Copy Fees Make check or money order payable to We require p ayment before we will process your request. Check box if you h ave an IFP/Fee Waiver Order from the court . Delivery Options U.S. Mail Email* Fax* Pick Up Other (pre - paid FedEx, UPS, etc.) * Plain copy and non - confidential documents only. American LegalNet, Inc. www.FormsWorkFlow.com