2. Full Name*
4. Date*
6. Company Name*
8. Street Number*
9. Street Name*
10. Street Type*
11. Apt #
13. City*
14. State*
15. Zip*
17. Phone Number
18. Email Address
20. What is your preferred method of communication in the event of question?
    -- Select One --PhoneEmail
24. Description of Requested Record(s)
    (Describe the specific public record(s) e.g., date, type, time period covering documents requested etc)
28. I understand that I will be contacted once documents have been identified. If production of records is requested, an estimated cost will be provided to me and I agree that I will be required to submit payment for duplication costs (and mailing) prior to the production of the requested documents.

    1. I wish to inspect city records

    1. Will pick up records

    1. Please mail
30. Please note that information contained in any PRA request is a public record and may be subject to public inspection pursuant to the CA Public Records Act.
32. By submitting this form, this serves as my online signature:
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field