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2. Name of Requestor*
3. Street Address
5. City
6. State
7. Zip Code
9. Email*
10. Phone*
11. Property Address*
13. Records Requested
15. Records Only

    1. Yes

    1. No

    Do you want to inspect the records only?
16. Records Format
    Medium in which the record is requested? (Note: The law does not require that any public records be produced except in the format by which they are kept by the Township)
18. Copies

    1. Yes

    1. No

    Do you want copies ($0.25 per page)?
19. Number of Copies
    How many copies would you like?
21. Certified Copies

    1. Yes

    1. No

    Do you want certified copies of records ($1 per page)?
22. Number of Certified Copies
    How many certified copies would you like?
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field