Forms

2. Payments: (must be received prior to releasing your records.)
   Payments may be made online (credit card), by mail (money order or check), or in person (credit card, money order, check, or cash).
4. Fees:*

   Please choose one or more of the options below:

   1. Copies Only
   2. Certification
5. Delivery Preference:*

   1. Mail
   2. Pick-Up
7. Plaintiff/Defendant Name:*
8. Date of Birth:*
10. Case / Complaint #*
11. Date of Incident:*
12. Charge(s):*
14. Requestor Information:
16. First Name*
17. Last Name*
19. Address*
21. City*
22. State*
23. Zip*
25. Contact Phone Number:*
26. NCourt Receipt #:*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field