REQUEST FOR MUNICIPAL COURT DOCUMENT COPY PERSON REQUESTING COPY: _____________________________ DATE: _____________ AGENCY OR FIRM: _______________________________________ SIGNATURE: __________________________________ ATTORNEY: _____________________________________________ APPOINTED DEFENDANT’S NAME D OF B TICKET/ CASE# HIRED TYPE OF DOCUMENT ARREST AFFIDAVIT ARREST AFFIDAVIT ARREST AFFIDAVIT ARREST AFFIDAVIT ARREST AFFIDAVIT NAME AND D.O.B. MUST BE FILLED OUT EXACTLY AS IT APPEARS ON THE DRIVER’S LICENSE RECORDS NOT PICKED UP WITHIN 30 DAYS WILL BE DISCARDED PLEASE FILL IN THE FOLLOWING FOR LETTERS OF DISPOSITION AND AFFIDAVITS NAME: ____________________________________________ D.O.B. _____________ TICKET CASE #: ______________ ADDRESS: ___________________________________________________________________ PHONE: ______________________ DATE & TIME OF COURT ____________________________ VIOLATION: _________________________________________________________________________________________________ DATE OF DEFENSIVE DRIVING CERTIFICATE RETURNED: _______________________ CHARGES: $2.00 - CERTIFICATES & LETTERS OF DISPOSITION UP TO 2 YEARS FROM DATE OF DISPOSITION $4.00 - CERTIFICATES & LETTERS OF DISPOSITION OLDER THAN 2 YRS FROM DATE OF DISPOSITION $5.00 - EACH DRIVING HISTORY RECORD $0.50 - COPY OF WARRANT, CITATION, PLEA DECLARATION PLEASE TAKE THIS FORM TO ANY SUB-STATION OR MAIL THIS FORM, WITH YOUR CHECK OR MONEY ORDER TO: MUNICIPAL COURT (If paying by check, there will be a hold for 30 days) 810 E OVERLAND EL PASO, TX 79901 OFFICE USE ONLY _______________________________________________________________________________________________________________ LETTER COMPLETED BY: _________________________________________ ________________________________ CLERK NO RECORD/CHECKED BY: _______________________________________ MAILED ( ) PICKED UP ( ) ________________________________ RICHARDA DUFFY MOMSEN MUNICIPAL COURT CLERK American LegalNet, Inc. www.USCourtForms.com