Request For Public Record Form

  • Indiana Access to Public Records Act - Indiana Code 5-14-3 ET SEQ
  • if applicable
  • Please Identify with reasonable particularly the record being requested
  • Requests for List of Names Address: Pursuant to Indiana Code 5-14-3-3(f), lists of names and addresses may not be disclosed to any individual or entity for political purposes or to commercial entities for commercial purposes. If the record being requested is a list of names and addresses, the Affidavit of Noncommercial and Nonpolitical Use must be completed and returned with this form.