Request for Public Records

2. First Name*

3. Last Name*

5. Address*

7. City*

8. State*

9. Zip*

11. Phone Number*

12. Email Address*

14. Fax Number

15. Is this a commercial request?*

    1. Yes

    1. No

17. Records*

    Please describe the public records you wish to receive. In order to expedite the search for the records, please be as specific as possible.

19. Department*

    1. Administration
    2. Building
    3. Clerk
    4. Community Development

    1. Finance
    2. Police
    3. Public Works
    4. Other

21. Signature of person making the request

    The City will respond to this request within five (5) working days.

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 that your ?electronic signature? is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
27. Date Received
    Date Received

28. Requestor Notified

29. Date Completed
    Date Completed

30. Notified By

32. Copy(s) 8”x11”:

    Total number of copies requested

33. Fee

    Number of copies x $0.15 =

35. Copy(s) Double-Sided:

    Total number of copies requested

36. Fee

    Number of copies x $0.20 =

38. CD(s):

    Total number of CDs requested

39. Fee

    Number of CDs x $2 =

41. DVD(s):

    Total number of DVDs requested

42. Fee

    Number of DVDs x $5 =

44. Labor:

45. Fee

    Labor x labor fee amount =

47. Miscellaneous:

48. Fee

50. Total Amount Due

52. Special Instructions

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit Submit and Print

* indicates a required field