Marilyn Burgess HARRIS COUNTY DISTRICT CLERK 201 Caroline | P.O. Box 4651 | Houston, Texas 77210 - 4651 | 832 - 927 - 5800 | www.hcdistrictclerk.com Request for Issuance of Service CASE NUMBER: CURRENT COURT: Name(s) of Documents to be served: FILE DATE: Month/Day/Year SERVICE TO BE ISSUED ON (Please List Exactly As The Name Appears In The Pleading To Be Served): Issue Service to: Address of Service: City, State & Zip: Agent (if applicable) TYPE OF SERVICE/PROCESS TO BE ISSUED: (Check the proper Box) Citation Citation by Posting Citation by Publication Citations Rule 106 Service Citation Scire Facias Newspaper Temporary Restraining Order Precept Notice Protective Order Secretary of State Citation ($12.00) Capias (not an E-Issuance) Attachment Certiorari Highway Commission ($12.00) Commissioner of Insurance ($12.00) Hague Convention ($16.00) Garnishment Habeas Corpus Injunction Sequestration Subpoena Other (Please Describe) (See additional Forms for Post Judgment Service) SERVICE BY (check one): ATTORNEY PICK-UP (phone) E-Issuance by District Clerk MAIL to attorney at: (No Service Copy Fees Charged) CONSTABLE Note: The email registered with EfileTexas.gov must be CERTIFIED MAIL by District Clerk used to retrieve the E-Issuance Service Documents. Visit www.hcdistrictclerk.com for more instructions. CIVIL PROCESS SERVER - Authorized Person to Pick-up: Phone: OTHER, explain Issuance of Service Requested By: Attorney/Party Name: Bar # or ID Mailing Address: Phone Number: American LegalNet, Inc. www.FormsWorkFlow.com