Form Center

Request for Public Records

2. 

4. Request for Records Pursuant to Indiana Access to Public Records Act (I.C. 5-14-3-1, et seq., as amended)
   Thank you for your interest in requesting records. Please give the following information:

   Thank you for your interest in requesting records. Please give the following information:

6. First Name*

7. Middle Name

8. Last Name*

10. Address 1*

12. City*

13. State*

14. Zip*

16. Phone Number*

17. Fax Number

18. Email Address

20. I am requesting the following information:*

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

22. Date range *

24. The City of New Haven may correspond with me regarding this request*

    1. by email (include above)
    2. by mail
    3. by fax (include above)

26. By signing this document, I understand that the city may charge a fee for providing copies of the requested public records, following the General Reproduction fee table.*

27. General Reproduction fee table
    General Reproduction fee

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field