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___________________

______________________ , 2016

RE: Public Records Request

ATTENTION: Records Custodian,

In compliance with Public Record Laws,


I, , would like to make an open public records request, for any
and all information subject to disclosure under public record laws for

Records Preservation

It is requested that all copies be made from the original record. In the event
information is missing from the original due to copy errors such as missing page numbers
that were later penned in or computer provided, or this isn’t a true copy of an original but
a copy of a copy, or any alterations such as highlighting or pen marks, please make such
note in the reply to our records request.

Please note anything destroyed per department records retention policy and the
time period for which it was held for.

Also, please forward the cost and payment method for the copies to be shipped to
the return address at the bottom of this letter.

signature

____________________________________

Ph:

Email:

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