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Public Records Request Form

2. 

4. CITY OF WEST MELBOURNE <br> 2240 Minton Road <br> West Melbourne, FL 32904 <br> Phone: 321-837-7783 <br> Fax: 321-768-2390 <br> recordsrequest@westmelbourne.org

   CITY OF WEST MELBOURNE
   2240 Minton Road
   West Melbourne, FL 32904
   Phone: 321-837-7783
   Fax: 321-768-2390
   recordsrequest@westmelbourne.org

7. PUBLIC RECORDS REQUEST FORM

   PUBLIC RECORDS REQUEST FORM

9. Note: Florida law does not require you to provide your name or complete this form. We ask for this information so that we may track the status of your request and ensure your request is met in a timely manner. Often, your request must be routed to a particular office where the information is maintained, or we might need to contact you to clarify your request. Our goal is to be as expeditious as possible in fulfilling your request.

   Note: Florida law does not require you to provide your name or complete this form. We ask for this information so that we may track the status of your request and ensure your request is met in a timely manner. Often, your request must be routed to a particular office where the information is maintained, or we might need to contact you to clarify your request. Our goal is to be as expeditious as possible in fulfilling your request.

13. In order that we may serve you, please provide specific description of item or items requested:

17. Requestor Name:

18. Date:
    Date:

20. Address:

21. Phone:

23. Email:

24. Need by:

26. Charge for Copies: 8 1/2 x 14 or smaller: $0.15/page Double-sided: $0.20/page Color: $0.25/page. In addition, there is a service charge for any reasonable time spent over and above 15 minutes to fulfill records request (the first 15 minutes shall be at no charge). This charge is determined based on the labor cost of the personnel providing the service. A cost estimate may be provided before the request is filled.

    Charge for Copies: 8 1/2 x 14 or smaller: $0.15/page Double-sided: $0.20/page Color: $0.25/page. In addition, there is a service charge for any reasonable time spent over and above 15 minutes to fulfill records request (the first 15 minutes shall be at no charge). This charge is determined based on the labor cost of the personnel providing the service. A cost estimate may be provided before the request is filled.

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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

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