Record-Search-Copy Request Form

Merced Superior Court 627 W. 21st Street Merced, CA 95340 (209) 725-4100 445 "I" Street Los Banos, CA 93635 (209) 725-4124 Record/Search/Copy Requests GC 70627(c) records or files The fee for a search of records or files conducted by a court employee that requires more than 10 minutes is fifteen dollars ($15) for each search. All requests received in the mail must be accompanied by a check with the amount left blank and include a note "not to exceed a dollar amount" on the check. Example: "Not to exceed $20.00" All requests must include a self-addressed-stamped envelope. All copies are $.50 per page, pursuant to GC 70627(a). All certified copies are $25.00 pursuant to section GC 70626(a)(4). All certified copies of Family Law Judgments for Dissolutions are $15.00 pursuant to GC70674. Off-site retrieval of files/documents is $15.00 pursuant to CRC 10.815(13)/GC70631. Complete one form for each search requested. Requestor's Name Phone Number Mailing Address Please provide us as much information you have in order to assist us with your search: Please indicate which case type you are requesting to be searched. A separate request and payment must be submitted for each type research request. Civil/Small Claims/Probate/Adoption Criminal Family Law Traffic Unknown For Family Law records please include the married name for each party. Name(s): (enter the name you wish to be searched) Court Location: Maiden Name: Merced Los Banos Add'l Names: AKA'S Date of Birth: Driver's License: For Family Law records please include the approximate year or year range. Case Number: (if known) Approximate filing date(s): Criminal and Traffic Matters: Violation/Charge: Violation Date: Information requested Copies ­ Please specify which document(s) you are requesting Certified Copies ­ Please specify which document(s) you are requesting to be certified: Sentencing Information Copies for the US Citizenship and Immigration Service Other Files pulled for viewing will be held for 10 days from notification. After 10 days, the files will be returned to archive and a new search and off-site retrieval fee will be required. Record/Search/Copy Request Form 10/2011 Rev 080814 American LegalNet, Inc. www.FormsWorkFlow.com