1

Date Of Request

 *

Date Of Request

2

Name of Requestor

 *

Name of Requestor

First Name:

Last Name:

3

Company

Company

4

Address

 *

Address

Street:	City:
State:	Zip:

5

 Contact Information

 *

Contact Information

Phone Number:

Email:

6

I hereby request, under Maryland's Public Information Act (PIA), State Government Article Section 10, of the Annotated Code of Maryland, (Check all that apply below)

 *

I hereby request, under Maryland's Public Information Act (PIA), State Government Article Section 10, of the Annotated Code of Maryland, (Check all that apply below)

to review

and/or have copies made of the requested documents.

7

I request the following public records (please be specific):

 *

I request the following public records (please be specific):

8

Please read the Cecil County Public Information Request Instructions, Click Here to review.

Yes, I have read the Cecil County Public Information Request Instructions provided in the link above

TERMS OF SIGNATURE AND SUBMISSION

I, the individual submitting this Public Information Request Form, warrant the truthfulness of the information provided in the submittal. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Signature and Filing.

9

Please type your First and Last Name (Electronic Signature) and date:  Then scroll down and submit

 *

Please type your First and Last Name (Electronic Signature) and date: Then scroll down and submit

First and Last Name

Date

 

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

To prevent spam we utilize a verification code system. Please enter the code as it is shown in the box below:

 

Code:

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