Public Request Form

Your Name: (required)

Your E-Mail: (required)

I, hereby request that the City of Tell City, Indiana (the "City") make the following records available for inspection and copying: (required)

Please provide a response to this request using the following method:

• On-site inspection only:

• By fax at the following number:

• By mail at the following address:

• By email at the following address:

I hereby acknowledge responsibility for the payment to the City of all reasonable charges incurred by the City to make such information available for inspection and copying:

Your E-Signature (please type your name as it will be considered as your signature): (required)

Telephone Number: (required)

Date: (required)*

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