Fax Express CHRIS DANIEL, Harris County District Clerk Customer Service Department Civil Fax Number 713-755-8980 To Be Completed By The Customer (Please Print): Case Number: _____________________________________ Style: _________________________________________vs. _____________________________________ Need Copy of (Please Check): DECREE /JUDGMENT DATE OF DECREE/ JUDGMENT: ___________ NUMBER OF COPIES: _____ ORDER/ DATE OF ORDER: _______________ NUMBER OF COPIES: _______ OTHER: _______________________________________________________________ Copies should be: ( ) CERTIFIED or ( ) UNCERTIFIED Criminal Fax Number 713-755-3731 STYLE: STATE OF TEXAS vs. _____________________________ AKA _______________ DOB1: _____ Defendant SPN: _____________ Social Security Number:__________________ Case Number: _________________ CRT: ______ Case Number:____________ CRT:_____ 1 If you do not know your case number or defendant’s SPN, we will need the defendant’s Date of Birth and Social Security Number, for researching purposes. Please note a $5.00 researching fee applies. ($5.00 for every 3 years prior to 1976) JUDGMENT/SENTENCE INFORMATION/INDICTMENT/COMPLAINT (Charging instruments) OTHER:____________________________________________________________________________ BACKGROUND CHECK (Letter of Disposition) MANUAL RECORD SEARCH (Prior -1976) ____year Copies should be: ( ) CERTIFIED or ( ) UNCERTIFIED TYPE OF DELIVERY: ( ) Mail 2 ( ) Will Call Pick Up Date 3: __________ ( ) Fax Express Return 4 CUSTOMER’S NAME (Please Print):_________________________________________________________ ADDRESS: _________________________ CUSTOMER’S PHONE NUMBER: _______________________ _________________________ CUSTOMER’S FAX NUMBER: __________________________ Applicable Postage and Handling fees will be charged 3 Will Call order must be picked up within 30 days from request 4 Fax Express Return service applies to Uncertified Requests Only  I hereby authorize the Harris County District Clerk to charge my credit card for payment of the services requested above: CREDIT CARD TYPE: _______________________________________________________________________________ CREDIT CARD NUMBER: _____________________________________ DATE OF EXPIRATION: _____________ NAME PRINTED ON CREDIT CARD: ________________________________________________________________ AUTHORIZED SIGNATURE: _______________________________________________________________________ CREDIT CARDHOLDER ADDRESS: _________________________________________________________________ CREDIT CARDHOLDER CONTACT NUMBER: ________________________________________________________ FOR DISTRICT CLERK’SOFFICE USE ONLY TRANSACTION NO: ____________________________ RECEIPT NO: ______________________ American LegalNet, Inc. www.FormsWorkFlow.com