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2. First Name*
3. Last Name*
5. Address
7. City
8. State
9. Zip Code
11. Phone Number*
12. Email Address*
14. Name of Defendant

    Please fill this out if you are requesting records for someone other than yourself. 

15. Birth Date
    Birth Date
17. Original Offense*

    What was the original charge/offense on your ticket?

19. Amended Offense

    Was your ticket amended to a lesser offense?

21. Date or Year of Incident*
    Date or Year of Incident
22. Date or Year Case Closed*
    Date or Year Case Closed
24. Case Outcome*

    What was the outcome of the case? Did you pay in full? Were the charges dropped?

26. Purpose of Request*

    Please explain why you need these records. The court can only provide you with public records but in some instances the entire file is not necessary. Please make sure to include the date you need this information.

28. Additional Notes/Comments
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field