Open Records Request

 

Town of De Beque Request for Inspection/Copying of Record

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Applicant Name &, Phone

First Name

Last Name

Daytime Phone

Description of Document:

Applicant Address

Address Line 1	Address Line 2
City	State Please select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPuerto RicoVirgin IslandNorthern Mariana IslandsGuamAmerican SamoaPalau
Postal Code

Purpose of Request

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Court CasePersonal InformationOther (Please Specify)

If other:

Certified Copy:

YesNo

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Signature:

Date

 

 

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