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Public Records Request Appeal Form
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I. Contact Information
Please provide any information necessary to address your appeal. At least one method of communication is required.
First Name
Last Name
Organization (if applicable)
Email Address
Address1
Address2
City
State
Zip
Telephone Number
Fax Number
Records Custodian Assigned
Request Reference Number
Original Request Date
II. Appeal Information
Appeal Type
Please check all that apply.
No response to Public Records Request.
Incomplete response or partial fulfillment.
Denial of fee reduction or waiver.
Improper withholding.
Additional information sought.
Other (specify below)
Appeal Summary
Supporting Documentation
Please upload any supporting documentation that you wish to have considered alongside your appeal.
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