2. Name of Requestor:*
3. Date:*
   Date:
5. Company Name:
7. Address1*
9. City*
10. State*
11. Zip*
13. Phone:*
14. Email Address:*
16. PLEASE LIST ALL DOCUMENTS THAT YOU ARE REQUESTING. Be specific regarding the description of information requested and if applicable include names, dates, and time period. For Police Department requests, list all known information such as case number, name of person(s) involved, location, time of incident, description of vehicle(s) involved and type of offense or incident.*
18. Select one of the below options:*
    -- Select One --I would like public information only. You agree to allow the City to withhold confidential information without requiring an Attorney General ruling.I would like public and confidential information. You are requesting an Attorney General ruling that could take 60 business days or more before receiving records.
20. I understand my rights according to the Texas Public Information Act. I also understand there may be charges for the records and that payment must be made before I obtain the records request. Please indicate if you would like to:*
    -- Select One --View information at City HallCome to City Hall and pick upRegular mail to address aboveEmailed to above email address
22. Typed Signature*
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24. Submit

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