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2. Email Address
3. Phone Number*
5. First Name
6. Last Name
8. ID Upload
10. Company Name
12. Address1
14. Address2
16. City
17. State
18. Zip
20. Request Details

22. Please be advised that the county may make reasonable charges not to exceed its actual cost incurred in accessing, duplicating, supplying, or searching for requested records.  Most routine FOIA requests do not incur any associated costs, however, should the county anticipate the assessment of charges, would you like a cost estimate in advance of us supplying the requested records?

24. Cost Estimate

    1. Yes
    2. No
26. Contact Information
    Questions call Lisa Beczkiewicz, Administrative Assistant/Deputy Clerk at 804-556-5811
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

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