Education Service Center Region 12 Public Records Request Form

This form is used to request public information under the Texas Public Information Act, § 6252-17a et seq.

Date *

YYYY

Your Name *

Mailing Address *

City, State Zip Code *

Email address *

I am requesting an opportunity to inspect or obtain copies of public records that... *

Describe the records or information sought with enough detail to allow for response. Be as specific as your knowledge of the available records will allow.

Please contact me if the fee for completion of the request will exceed ... *

Are you a member of the media? *

My request is related to news gathering purposes

Yes

Other:

Required

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