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Public Information Request
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FIRST & LAST NAME:
MAILING ADDRESS:
CITY:
STATE:
ZIP:
PHONE NO.:
EMAIL:
NAME OF FIRM OR COMPANY REPRESENTING (if applicable):
INDICATE PREFERENCE: A COPY OR VIEWING/INSPECTING THE RECORD(S):
DESCRIPTION OF PUBLIC RECORD(S) BEING REQUESTED: (Attach additional information if needed.)
I understand I am responsible for any applicable charges as a result of this open records request.

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