COMMONWEALTH OF PENNSYLVANIA COUNTY OF: Magisterial District Number: MDJ Name: Request for Official Records of the Magisterial District Courts Address: DATE OF REQUEST: Telephone: ( ) APPLICANT CONTACT INFORMATION: (Please Print) NAME: ADDRESS: DAYTIME TELEPHONE: ( ) CASE TYPE: (Check all that apply) Civil Non-Traffic Criminal Traffic Landlord/Tenant Miscellaneous DESCRIBE INFORMATION REQUESTED: (See instructions on following page) Official Use Only CHARGE Comments Date Received Tracking Number (if applicable) Total Cost MDJS 200-10 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR OBTAINING OFFICIAL CASE RECORDS OF THE MAGISTERIAL DISTRICT COURTS 1. A requestor shall identify or describe the records sought with specificity to enable the court staff to ascertain which records are being requested. A request need not include any explanation of the requestor's reason for requesting or intended use of the records. The requestor may submit the completed form to the appropriate magisterial district court. Incomplete forms may result in delayed access to the requested record(s). Requestors may be charged reasonable fees for access to court records. Fees for photocopying shall not exceed $0.25 per page. Requests will be completed as promptly as possible under the circumstances existing at the time of the request. If the court denies the request or must delay access, the court shall inform the requestor in writing of the specific reason(s) why access to the information is being delayed or denied. If a request is denied by the court, the decision may be appealed to the president judge or designee within 15 business days of service of the written notification by the magisterial district court denying the request. 2. 3. 4. 5. For Court Use Only Your request was received on / / . In accordance with the Public Access Policy of the Unified Judicial System of Pennsylvania: Official Case Records of the Magisterial District Courts, please be advised that: this request is being returned to you because it does not contain sufficient information to evaluate your request. No further action will be taken unless you resubmit the request with additional information. the information/record does not exist. the information/record is not an official case record as defined by the Policy. the information/document is exempt from public access pursuant to the Policy. you have failed to properly complete the Request Form . Other Signature Date For Use by Requestor If you wish to appeal the decision set forth above, please complete this section and submit this entire form to the President Judge of the county or his/her designee within 15 business days of notification of the decision. I, , request that a review of the decision set forth above be made. Signature Date MDJS 200-10 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com