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Public Records Request

2. First Name*

3. Last Name

5. Company Name

7. Address1

9. City

10. State

11. Zip

13. Phone / E-mail address*

15. INFORMATION BEING REQUESTED

    For each record, describe type, date, subject, title, etc. Please be very specific.

19. For Official Use Only

    File Shown

21. Processed by:

22. Mail, Pick-up, Cost:

Leave This Blank:


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

    This field is not part of the form submission.

26. Submit

* indicates a required field