Free Copy and Search Request Form - Houston Division - Texas

United States District Court Southern District of Texas Houston Division Fax: 713-250-5356 Phone: 713-250-5500

Copy Request Form and Credit Card Authorization Date: Firm: Address:

Requested by: Credit Card: Card Number: Signature of Card Holder: ____ Visa ____ Master Card

Phone: ____ American Express Expires: _____ Discover

Case Number:

Case Name:

Documents Requested ­ ($0.10 per page for electronic documents, $0.50 for paper documents)

Do you require Certified copies? ($9.00 fee per document certified) Search Requested ­ ($26.00 fee for Certificate of Search)

Please send documents via: Fedex Account Number:

Mail ___________ ____________________________

Pick-up ___________