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2. First Name*
3. Last Name*
5. Address 1*
7. Address 2
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address*
16. Is this a commercial request?*

    1. Yes

    1. No
18. 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. The PIA does not require the County to provide information not contained in public record or to create such a record if it does not exist at the time of the request. In accordance with the Public Information Act, the County charges reasonable fees for copying as well as search and preparation of records.
20. Department*

    1. Administration
    2. Finance
    3. Community Development
    4. Corrections

    1. Emergency Services
    2. Parks, Recreation & Tourism
    3. Public Works
    4. Other
22. Signature of person making the request
    The County has 30 days from receipt of your request to respond.
24. Do you agree?*

    By clicking I agree, you agree and acknowledge that 1) your request 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
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26. 1. Receive an email copy of this form.
27. Email address

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