GRAMA REQUEST FOR RECORDS

Name *

Address *

Address

City

State/Province

Zip/Postal

Country

Daytime Phone Number *

E-mail *

Description of record sought *

Check any and all that apply: *

I would like to inspect the records.

I would like to receive copies of the record. The cost for copies of police reports is $10.

I am the subject of the record.

I am the person who provided the information.

I am authorized to have access by the subject of the record or by the person who submitted the information.

I authorize up to the following amount and understand that I will be contacted if there are additional costs. *

Payments must be made at CASHNET, under "GRAMA Report".

NOTE:

Copies of the information being requested will be provided as soon as reasonably possible. The law provides 10 business days after receiving a written request to provide the record, deny the request, or notify the requester that it cannot immediately provide a response due to extraordinary circumstances.
This request may be delayed if all the information is not provided.

Electronic Signature of Requestor *

Date of Request

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