ANNIE REBECCA ELLIOTT DISTRICT CLERK Fort Bend County, Texas REQUEST FOR DATA INFORMATION ATTENTION: Joyce Walshak 1. Describe information. Please be specific and detailed. You may use back of this page if necessary. __________________________________________________________________________ 2. Format: Report CD-ROM Diskette 3. Date needed: ___________________ 4. Name of contact person:___________________ Phone and/or ext. number: ___________________ 5. Mailing address if mailing requested: ____________________________________________ Street ___________________, ___________________, ___________________ City Texas Zip 6. If your office is in the courthouse complex, the information will be sent to you through the county mail delivery. If you wish to have information mailed, complete number five. Please be specific when describing the data you are requesting. Please call: Joyce Walshak at 281-341-4464 if you have any questions. All requests must be in WRITING. Name of person requesting information: ____________________________________________ Date: ___________________ District Clerk’s signature: ____________________________ Date: ___________________ Thank you. ANNIE REBECCA ELLIOTT DISTRICT CLERK Cost Report: $5.00 Administrative Fee per request $5.00 – (one to twenty-five pages) $10.00 – (twenty-six to fifty pages) $25.00 – (fifty-one to seventy-five pages) $50.00 – (seventy-six to one hundred pages) $100.00 – (one hundred one pages; every fifty pages thereafter are $25.00) Postage Media CD-ROM/Diskette: $26.00 Administrative Fee $10.00 per CPU Minute Postage $ 1.00 Media Fee Data Request Revised: 2007/01 301 Jackson Richmond, Tx 77469 Phone: (281) 341-4464 American LegalNet, Inc. www.FormsWorkflow.com