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2. First Name*
3. Last Name*
5. Business / Organization Name
7. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email Address*
18. Records*

    Please describe the public records you wish to receive. In order to expedite the search for the records, please be as specific as possible.

20. Signature of person making the request
    The Town will respond to this request within five (5) working days.
22. Do you agree?*

    By clicking "I Agree", you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
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24. 1. Receive an email copy of this form.
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