Form Center

2. Michigan Freedom of Information Act 

   Request for Public Records

4. Name of Requester:
6. Address
8. City
9. State
10. Zip Code
12. Contact Phone Number
13. Contact Email:
15. Please state the name of the public record you are requesting and include the following:
17. Names Referred to in Record:
18. Date of Record:
20. Incident/Case Number
22. Location of Event:
24. Other helpful information to identify the record:
26. Method of Access Desired:

    1. Pickup
    2. Email
    3. Mail
    4. Examine
28. Mailing Address (If different than above):
29. City
30. State & Zip
32. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
34. Electronic Signature
35. Date:
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field