2. First Name*
3. Last Name*
5. Mailing Address*
7. Mailing Address 2
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address*
16. Records Requested*
    Please describe the public records you wish to receive. In order to expedite the search for the records, please be as specific as possible, describing types of records, dates, subject matter, etc. The public body will make every reasonable effort to assist you in identifying the records being sought. Requests for voluminous records may be delayed beyond the 15 day time allotment.
18. Please Note:
    There may be a cost involved in responding to your request. The public body can require you to examine the records at the office of the public body. Refer to the public body's policy or regulations for information about costs and access to records.
20. Please contact me if the costs will be greater than:
21. Cost:*

    1. $5.00
    2. $10.00
    3. $50.00
    4. $100.00
23. Do you agree?*

    By clicking "I Agree" you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree and understand the public body must, within 15 business days from the receipt of this request, either provide you with access to the records, deny your request, or state that additional time is needed.

    1. I Agree
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25. 1. Receive an email copy of this form.
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