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3. Last Name*
5. Mailing Address*
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11. Phone Number*
12. Email Address*
16. Records Requested*
    Please describe the Public Records you wish to receive. In order to expedite the search for the records, please be as specific as possible.
18. Department*

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20. Signature of person making request*
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    By clicking I agree, you 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 hand signature.
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