Illinois > Local County > McHenry > General
Application For Remote Access Service - Illinois
| Application For Remote Access Service Form. This is a Illinois form and can be used in General McHenry Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
APPLICATION FOR REMOTE ACCESS SERVICE FROM 19TH JUDICIAL CIRCUIT - McHENRY COUNTY I would like to apply to the 19th Judicial Circuit, McHenry County, for remote access to electronic maintained court information. I understand and agree to pay the established fees for the use of this convenient method for access to official court records. I understand that this fully completed application will be acted upon within 15 days of receipt. Date of Request: ______________________________________________________ __________ Name of Requester: _____________________________________________________ _________ Address of Requester: _________________________________________________ ___________ ________________________________________________________________________ ________ Phone Number: _____________________________E-mail Address:_____________ __________ Name of Company/Agency or Firm: _________________________________________________ List of names of personnel utilizing system: __________________________________________ ________________________________________________________________________ ________ Describe Information Requested (Be Specific): ________________________ ________________ ________________________________________________________________________ ________ Reason Information Desired: ____________________________________________ ___________ ________________________________________________________________________ ________ Specify how information will be utilized: _____________________________________________ ________________________________________________________________________ ________ List Persons or Organizations to whom info rmation will be disclosed or distributed: ________ ________________________________________________________________________ ________ I certify that all of the information contained in this application for Remote Electronic Access service is true and correct. Dated: ________________________ __________________________________________ ____ Signature of Requester ______________________________________________ Print Name McHenry County Remote Access Application - Page 1 of 1 Revised 9/8/04:kk American LegalNet, Inc. www.USCourtForms.com
|
|||||||
