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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. Description of Request Records*
18. Pursuant to O.C.G.A.§50-18-70, et. Seq, I am formally requesting to:
    -- Select One --Inspect / Review RecordsObtain Copies of Records
20. Do Copies Need to be Certified:

    1. Yes
    2. No
22. Preferred Manner of Delivery:
    -- Select One --In PersonMailFax if PossibleE-mail if Possible
24. Signature of person making the request
    The City will respond to this request withing Three (3) working days.
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
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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