PUBLIC RECORDS REQUEST
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NAME *
ADDRESS *
TELEPHONE *
ALTERNATE TELEPHONE
EMAIL *
FAX
I wish to receive a copy of the following record(s): (Specify)
I wish to review the following record(s): (Specify)
I understand I will be contacted within five (5) business days, excluding weekends and holidays, as to when I may view these records. I also understand that I may be charged a fee for search, review, and copying costs related to this request. I further understand I am not allowed to remove any record(s) from the office where they are maintained.
Print Name *
Date *
Submit
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