PUBLIC RECORDS REQUEST FORM

Your information

Name

First

Last

Phone

Address

City

State/Province

Zip/Postal

Address

Are you a Tennessee citizen?

Request:

Inspection (The TPRA does not permit fees or require a written request for visual inspection only.)

Copy/Duplicate

If costs for copies are assessed, the requestor has a right to receive an estimate. Do you wish to waive your right to an estimate and agree to pay copying and duplication costs in an amount not to exceed $

If so, type initials here:

Delivery preference:

On-Site Pick-Up

Electronic

USPS First-Class Mail

OtherOther

Records Requested: Provide a detailed description of the record(s) requested, including: (1) type of record; (2) timeframe or dates for the records sought; and (3) subject matter or key words related to the records. Under the TPRA, record requests must be sufficiently detailed to enable a governmental entity to identify the specific records sought. As such, your record request must provide enough detail to enable the records custodian responding to the request to identify the specific records you are seeking.

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