Form Center

2. Requester Name (First, Last)
3. Date of Request
5. Email
6. Phone Number
8. Address
10. City
11. State
12. Zip Code
14. Note: MS § 13.05, subd. 12, persons may not be required to identify themselves, state a reason for, or justify a request to gain access to public government data. A person may be asked to provide certain identifying or clarifying information for the sole purpose of facilitating access to the data.
16. Description of the Information Requested
    Please be as specific as possible about your request.
18. How do you prefer to receive your data?*
    -- Select One --I would prefer paper copies ($.25 per sheet)I would like to view the data in person at City Hall. I would prefer to receive Electronic files if applicable.Please save all Electronic Data to a CD. ($10.00 per CD)

    Please select one of the following. Please note that some files may be too large to send via Email. The City does offer CD's for requests that are too large for Email.
20. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
22. Electronic Signature
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field