Records Request Form – City Of Florence

REQUEST FOR ACCESS TO PUBLIC RECORDS
CITY OF FLORENCE, ALABAMA

Name *

Email *

Address *

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PHONE: (Day) *

PHONE: (Evening) *

If you wish to REVIEW documents, please fill in this section: I REQUEST TO REVIEW THE FOLLOWING PUBLIC RECORDS OF THE CITY OF FLORENCE (SEPARATE FORM NEEDED FOR EACH DOCUMENT REQUESTED): *

If you wish to receive COPIES of documents, please fill in this section: I REQUEST TO RECEIVE COPIES OF THE FOLLOWING PUBLIC RECORDS OF THE CITY OF FLORENCE (SEPARATE FORM NEEDED FOR EACH DOCUMENT REQUESTED): I UNDERSTAND THAT THERE IS A COPY FEE OF 10 CENTS PER PAGE: *

I agree that I shall not cause harm or damage to any public record which | am reviewing. | understand that records being reviewed shall not be removed from the area in which said records are being reviewed. | also understand that the City Official or employee listed below will be forwarded a copy of this request and that | will be contacted by the appropriate City Official or employee to arrange an appointment to review the records requested.

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Signature

Date

if you have any questions regarding your request, please contact the department listed above.

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