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GRAMA (records) Request
Leave This Blank:
Requester's Complete Address:
City, State, and Zip Code
Requester's Daytime Phone #:
Requester's Email Address:
Not Applicable because the record is public
I am the subject of the record
I am the parent or legal guardian of a minor who is the subject of the record
I have power of attorney or notarized release from the subject of the record or provider of the information
I have a legislative subpoena or court order
I understand that I may be responsible for the actual costs associated with providing this information.
Inform me of the cost prior to completing my request
Description of Record(s) Requested (Must be detailed)
For Office Use Only
Response to Record Request
Approved / Date
Sent/Picked Up Date
Request for extra ordinary circumstances
(If approved) It is estimated that the record will be available on
Name of Record Provider
* indicates required fields.
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