2. This form is recommended to expedite your request.
   **Note to Requester: Retain a copy of this request for your files. If you eventually need to file a Request for Review with the Public Access Counselor, you will need to submit a copy of your FOIA request.**
4. First Name*
5. Last Name*
7. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email Address*
18. Is this a commercial request?*

    1. Yes

    1. No
20. Records*
    Please describe the public records you wish to receive. In order to expediate the search for the records, please be as specific as possible.
22. Department*

    1. Police
    2. Building
    3. Public Works
    4. Clerk

    1. Community Development
    2. Administration
    3. Finance
    4. Other
24. Signature of person making the request
26. 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
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field