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2. View FOIA procedures and guidelines:
   FOIA procedures and guidelines
4. Requester Information:
6. First Name*
7. Last Name*
9. Address 1*
10. Address 2
12. City*
13. State*
14. Zip*
16. Phone Number*
17. Email Address
19. How do you want your records provided?*

    1. Paper Copies

    1. Electronic Copies

    1. Inspection
21. Confirm Email Address
23. Public records desired: (check all that apply)*

    1. Police Report
    2. Accident Report/UD10

    1. Attachments
    2. Video

    1. Photos

    1. Other
25. Describe other type of record desired:

27. Note:  Video is not able to be sent electronically - requests that contain video will need to be picked up or will be mailed

29. Identifying description of records desired:*
    Please describe the public records you wish to receive. To ensure you are provided the correct documents, please provide as much detail as possible. When requesting Police Department reports, please provide the incident report number, the date of the occurrence, the location and the parties involved, if known.
31. Do you agree?

    I understand a public body must respond to my request within five (5) business days after it is received (If a request for a public record is received by facsimile or e-mail, the request is deemed to have been received on the following business day). The public body must grant or deny all or a portion of my request, or issue a notice extending for ten (10) business days, the period in which the public body must respond to my request. In place of these deadlines, I agree to allow the public body a reasonable time to process my request. I understand I have the right to appeal the City's response to the City Commission, in writing, that specifically states the word "APPEAL" and indicates the reason or reasons for reversal of the response, or seek judicial review in the Circuit Court within 180 days of a final determination of a request. The burden of proof in Court is on the public body. If the Court determines that the public body has been arbitrary and capricious in not disclosing a public record, it may award, in addition to actual and compensatory damages, punitive damages not exceeding $1,000.00. I acknowledge that from the time that I, or the organization I represent, have been granted access to a "motor vehicle accident report" until thirty (30) days after the date the report is filed, both I and the organization I represent (if any) are prohibited from: (a) using the report for any direct solicitation of an individual, vehicle owner, or property owner listed in the report (b) disclosing any personal information contained in the report to a third party for commercial solicitation of an individual, vehicle owner, or property owner listed in the report. This statement is made pursuant to Public Act 218 of 2013 and I further acknowledge that a person that knowingly violates section 503 of Public Act 218 of 2013 is guilty of a crime punishable by a fine or imprisonment or both.

    1. I Agree
33. Signature of person making the request
    The City will respond to this request within five (5) working days.
35. *A confirmation page will pop-up once your request has been submitted. You must allow pop-ups for this site to be able to view the confirmation page.
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50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

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