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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:


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

    This field is not part of the form submission.

57. Submit Submit and Print

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