APPLICATION FOR OPEN RECORDS REQUEST

This request is made under the Texas Open Records Act, Tex. Rev. Civ. Stat. Art 625217a. In accordance with Section 4 of the Act, which requires the custodian of records to produce public information for inspection, duplication, or both, in the offices of governmental bodies, I hereby request:

Records Request: Access to review the following (Please fill in as completely as possible):

Requestor's Name:
Requestor's E-mail:
Requestor's Address:
City: State: Zip:
Requestors Phone Number: Please include area code.
Ext.(Optional)