Request to Inspect Public Records

Date*

REQUESTOR INFORMATION

Company Name

First Name*

Last Name*

Address*

City*

State*

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming

Zip*

Phone*

Email*

Please check the appropriate box and be as specific as possible on documents:

I am requesting to*

•   Inspect
•   Obtain Copies

Please identify the records sought with reasonable particularity:*

I would like to receive the requested documents via:*

•    E-mail
•    Mail

MFA may charge reasonable fees for copying the public record. You will be notified in writing/email of the fee for your requested documents and payment can be made by check payable to MFA.

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