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2. CASE NO.
3. Please note:

   If you do not know your case number, please call the Van Buren County Friend of the Court office at  (269) 657-7734 to ensure that we can properly identify your case and provide you with your requested documents.

5. Name of person requesting account history*
6. Relationship to case*

   1. Plaintiff
   2. Defendant
   3. Third Party Payee
   4. Attorney
8. Residential Address*
9. Apt/Lot #
11. City*
12. State*
13. Zip Code*
15. Mailing Address*
16. Apt/Lot #
18. City*
19. State*
20. Zip*
22. Phone Number*
23. Email Address*
25. Name of other person on case*
27. Check One:*

    1. I am the payer on this docket.
    2. I am the payee on this docket.
28. Reason for request:*

    1. Housing verification
    2. Social Security verification
    3. Other
30. If other, please state the reason for your request:
32. Dates needed:

    I request a detailed account history of the docket number above. 

33. Beginning:*
    Beginning:
34. Ending:*
    Ending:
36. I am requesting:

    1. For my account history to be mailed to my address on file with the Friend of the Court office.
    2. To pick my account history up in person from the Friend of the Court Office.
38. Please note:

    Mail: We will only mail account histories to the address on file with the Friend of the Court. 

    In-person: If you choose to receive your account history in person, you will be required to show your state issued ID or driver's license. Account histories may not be picked up by anyone other than the requestor or a party on the case.

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field