Request,Application: Andrew John Le Roy vs The State of Texas

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                                FORT BEND COUNTY CLERK’                                      OFFICE
                                          CIVIL COPY REQUEST
Complete the Copy Request form. Complete the payment for copy request. Instructions
for processing credit card payments, please review Credit Card Payment page. Send the
completed copy request form along with payment information to cclerk@fortbendcountytx.gov for
processing.

DATE:     (9-23-23                        CAUSE NUMBER:        é    —-CCU- (SOV

                                                               vs


Name of Person/Company       Requestin,          wdrenw        (ea
Address:
Telephone:     Gol ~ Fay    - 399                    Email:         2   reso ylerou   ocr).    cozy

        CALL FOR PICKUP               CALLED CUSTOMER FOR PICKUP ON
        HOLD FOR PICKUP
        MAIL WHEN READY
        EMAIL WHEN READY

 lease Check One (1):                                                                                       mo
                                                                                                            =

                                                                                          R
       Non-Certified Copy (Plain) $1.00 per page                                                            SS
                                                                                                            a
       Certified Copy -Paper (Seal) $1.00 per page PLUS $5.00 per certification
                                                                                                             =
LT] E-Certified Copy (Seal) $1.00 per page PLUS $5.00 per certification
List of Copies Needed:
Number of Pages Copy Of
           Petition
           Citation
              Answer                                                                                          nN
              Judgment
              Other: cee Patna)             Wee
              Other:
              Other:
              Other:
                                                                                              Com. @
Escrow Users, Please Check One:            CC)   Do Not Charge to my Account
                                                 Charge to my Account Number
*** If you pay by check, the following is required: Printed name, address & phone number on the check
                                                          Date of birth and driver’s license number of signer.

                             ALL REQUESTS MUST BE SIGNED.
Confidential information may be redacted from the LL                                     VL.


                                                          ae        Signature of Person Requesting
Made py       Dy         Amount Due: $       ®
              Injtials
CASH.                               CHECK #                             RECEIPT #0
                                                                                 OR BRA- CC UC
                                                                                                        CIVIL COPY REQUEST
                                                                                                       iNCIVILICOPYREQ.DOC