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CITY OF BROCKTON

PUBLIC RECORDS REQUEST FORM

Public records request will be responded to within ten (10) business days from receipt of request. Responses may identify additional information and or time need to complete the request. In accordance with Public Records Law, EXEMPTIONS will be redacted or otherwise withheld from materials provided.

Please be as specific as possible when identifying records requested. The first two hours of work performed to respond to a public records request are free of charge. After that, there will be a charge up to $25.00 per hour. The city may charge up to $0.05 for black and white paper copies and may charge the actual cost of electronic storage devices (i.e. DVDs, memory sticks, etc..).

REQUEST INFORMATION

Date of Request:

City Department Requesting From:  

Detailed Descripting of the Records Requested:  

Date Range (If Applicable):   To  

REQUESTER'S INFORMATION

Name:    

Firm/Company:  

Address:  

City/Town:   State:  Zip: 

Phone No.:   Fax No.:  

Email:      

Response Format:  

 

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