REQUEST FOR CITATION DISTRICT CLERK, POTTER COUNTY, TEXAS (Instructions: Complete this form, Sign it, include Self- Addressed Stamped Return Envelope and MAIL it to: District Clerk, Potter County, P. O. Box 9570, Amarillo, TX 79105 CAUSE NUMBER: Date: Cause number must be provided Style of the Cause: I hereby request the District Clerk of Potter County to issue citation/s in the above captioned cause to the following defendant/s and direct the Clerk to deliver the citations as noted beside each defendant for service: Defendant/s Name & Address - - - Deliver for service to: Use additional forms if necessary. I have enclosed (circle one): a LAW FIRM CHECK, CASHIER'S CHECK or MONEY ORDER (no personal checks accepted) in the amount of: $_______$8.00 per citation $_______$60.00 each. For Potter County Sheriff Fees $_______TOTAL ENCLOSED Signature of Requestor Address of requestor American LegalNet, Inc. www.FormsWorkFlow.com