Public Records Request Form

2. First Name

3. Last Name

5. Company (If Applicable)

7. Address1

9. City

10. State

11. Zip

13. Home Phone

14. Cell Phone

15. Email

17. Fax

18. Preferred Method of Contact
    -- Select One --Home PhoneCell PhoneFaxIn personEmail

20. Total Number of Copies Requested

22. Record Description*

    For each record, describe the type, date subject, title, etc. Please be as specific as possible.

24. Copying Fees

    <ul><li>$0.50 for the first page</li><li>$0.15 for each additional page</li><li>Research charge when applicable</li></ul>

    • $0.50 for the first page
    • $0.15 for each additional page
    • Research charge when applicable

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit Submit and Print | Go Back