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2. First Name*
3. Last Name*
5. Representing Firm/Company
6. Date*
   Date
8. Address*
10. City*
11. State*
12. Zip*
14. Phone Number*
15. Email Address*
17. Records Requested*

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

    There may be charges associated with production of the requested information. An invoice will be sent if fees apply.

19. Please indicate what you would like to do:*

    1. View the information requested

    1. Receive copies of the information
21. Signature of person making the request*

    The City will respond to this request within ten (10) 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
25. FOR OFFICE USE ONLY
27. RECEIVED BY:
28. SENT TO:
29. PIA#:
30. DUE DATE:
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

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