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First Name
Last Name
Phone Number
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Description of Records Requested (Please be specific and include as much detail as possible)

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I understand there is a charge for copies of public records. I understand I will receive a written estimate for production of the records indicated above if the estimated cost is expected to be over $25.00, which I will be required to pay in full prior to inspection or reproduction. Materials will be held for 30 days. If not retrieved, advanced payment will not be returned.*