Court Delivery Form

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Fax Express
Chris Daniel, Harris County District Clerk
Customer Service Department
Civil (ONLY)
Fax Number 832-927-0141
To Be Completed By The Customer (Please Print or Type):
Case Number: _____________________________________
vs. ________________________________________
Style: ________________________________________
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 and/or Raised Seal □ or □ UNCERTIFIED All copies, certified or uncertified are $1.00 per page.
Criminal (ONLY)
Fax Number 832-927-0137
STYLE: STATE OF TEXAS vs. ________________________________ AKA _____
1
DOB
: ____ 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 if we have we do the search for you. ($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
3
4
Fax Express Return
(customer will be contacted)
CUSTOMER’S NAME (Please Print): _________________________________________________________________
ADDRESS: ________________________ CUSTOMER’S PHONE NUMBER: _________________________
_______________________ CUSTOMER’S FAX NUMBER: ____________________________
3
Applicable Postage and Handling fees will be charged
Will call customers will be contacted when request are completed. Will
4
call orders must be picked up within 30 days of request completion.
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: Make
SURE to sign for credit card payment.
CREDIT CARD TYPE: _____________________________________________________________________________
CREDIT CARD NUMBER: ____________________________________DATE OF EXPIRATION: _______________
NAME PRINTED ON CREDIT CARD: ________________________________________________________________
**AUTHORIZED SIGNATURE: _____________________________________________________________________
CREDIT CARDHOLDER ADDRESS: _________________________________________________________________
CREDIT CARDHOLDER CONTACT NUMBER:_________________________________________________________

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