26th Judicial District
SelfServe Center

Please read the following acknowledgement and answer questions to gain access to the SelfServe Center forms.


Acknowledgement: By typing your name below, you acknowledge the following:
  • I understand that the SelfServe Center and its staff cannot represent me in court or give me legal advice or assistance.
  • I understand I am not entitled to any guarantees of confidentiality while using the SelfServe Center.
  • I am over the age of 18 years.
  • I am able to read English and/or requested explanation of any parts of the form I did not understand
  • I fully understand the contents of this form.
  • I agree to these conditions knowingly, willingly and voluntarily. 
If I cannot read, this form has been read and explained to me by:

Please provide the following Information for our records.   * Fields are required.

1.
*  First Name:
   Middle Initial:
*  Last Name:
2.
*  Zip Code:
3.
* Current Date (MM/DD/YYYY)
4.
*  Ever visited the SelfServe Center in person?
Yes
No
5.
*  Reason for acessing this site:
If Other, please specify:
6.
*  How did you learn about this website?

The following information is voluntary and are appreciated.  Your answers are for statistical records and help to improve the SelfServe program.

7.
Age:
18 - 25
26 - 35
36 - 45
46 - 55
56 or over
8.
Sex:
Female
Male
9.
Language:
English
Spanish
French
Other
10.
Education:
8th grade or less
Some highschool
Completed highschool
Some college
College grad
Advanced degree
11.
Ethnic Background:
Caucasian
African American
Native American/Eskimo
Hispanic/Latino
Asian
Other
12.
Income Level:
$0 - $9,000
$9,001 - $25,000
$25,001 - $40,000
$40,001 - $50,000
Over $50,000
13.
Please explain why you decided to represent yourself:
14.
Suggestions for improvements or comments: