Rennillo

Online Record Request Form

Use this online form when you need to obtain records from third parties via a request and authorization or a subpoena.

You can also use our fillable form on the Resources page of this site.


Obtain Records for:
	Required Fields - *
* Firm Name:
Address 1:
Address 2:
City:
State / Zip:

* Contact Person:
* Attorney:
* Telephone:
Fax:
* Email:
Representing:	Plaintiff Defendant
Opposing Counsel:
Serve Notice:	Yes No
* Firm Name:
Address 1:
Address 2:
City:
State / Zip:
* Attorney:
Telephone:
Email:
Representing:	Plaintiff Defendant
Attach service list for additional opposing counsel:
Additional information/Additional opposing counsel:
Records Pertain To:
Name:
Date of Birth:
Social Security #:
Case:
Case Caption:
-vs-
Case Number:
Judge:
Court
State:
Federal:

Deponent #1:
* Full Name:
	Rush: Verify Address:
Address:
City:
* State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #2:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #3:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #4:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #5:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #6:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #7:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Deponent #8:
Full Name:
	Rush: Verify Address:
Address:
City:
State / Zip:
Records Requested: Any and All Only Any and All, Including but not limited to
Obtain Authorization Authorization Attached

Bill:
Requesting Attorney Direct Billing Contact Me

Direct Billing Information:
Company:
Attention:
Address:
City:
State / Zip:
Telephone:
File #:
I authorize Legal Record Services to represent my signature on any request/subpoena with the same force and effect as if I had personally signed.

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