Open Records Request Form

Section A - Requestor Information

Name

First

Last

Mailing Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone Number

Enter your area code and phone number

ex: myname@example.com

Please provide a detailed description of the records requested; be specific as possible (dates, type of record, creator of record, etc.).

Request Description

Division

Preferred method of receiving requested records:

U.S. Mail

Fax

In person pick up

Review in person/copy

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