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2. Date of Request*
   Date of Request
   (response will be within (5) working days after receipt)
4. First Name
5. Last Name
7. Company Name (if applicable)
9. Address
11. City
12. State
13. Zip Code
15. Phone Number*
16. Fax Number
18. Email Address
20. Records sought (be as specific as possible: type of records, include address of property, dates/timeframe, etc.)*
22. I am the owner of the property for which the records are being requested.*

    1. Yes

    1. No

    1. N/A
24. It is a violation for a person to knowingly obtain public records without disclosing that it is for commercial purpose.
    Are the records sought for a commercial purpose?*

    1. Yes
    2. No

    (Response within 21 working days.)

26. Would you like to receive the requested information electronically, if feasible?*

    1. Yes

    1. No
28. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature
32. Reproduction Costs
    No Charge for first 50 pages of black and white (letter/legal sized copies)
    After the first 50 copies, the fee is $.15 per pg. for black & white copies ($.25 per pg. for color) (letter/legal size)
    $.25 - 11" X 17" ($.50 - color copy)
    $3.00 - Large Coies (2'x3' or larger)
    $1.00 - CD
    $5.00 - Motor Vehicle Accident reports
    $1.00 - Certification Cost (by Clerk's Office)
    $1.00 - DVD
    
    Prices are subject to change, without notice.
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34. Submit

* indicates a required field