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PUBLIC RECORDS REQUEST FORM - CITY OF FAIRBURY

CITY OF FAIRBURY PUBLIC RECORDS REQUEST
The City will respond to this request for public records pursuant to Neb. Rev. Stat. §§ 84-712 to 712.09 and all other applicable law. The City, in providing this form for your request, does not guarantee it may disclose the public records requested, and does not waive any rights, obligations, or options available to it pursuant to law in responding to this request. The City reserves the right to withhold certain public records pursuant to Neb. Rev. Stat. §§ 84-712 to 712.09 and all other applicable law.
NAME*
ADDRESS:*
CITY:*
STATE:*
ZIP CODE:*
TELEPHONE NUMBER:*
DATE REQUESTED:*
DATE REQUIRED:*
FAX NUMBER:
DESCRIPTION OF REQUEST:*
INSTRUCTIONS:
When information is compiled you will be contacted by phone. Below is an estimate of the expected cost of the copies requested. You have 10 business days from receipt of this notice to review the estimated costs, and (1) request the City to fulfill the original request, (2) negotiate to narrow or simplify the request, or (3) withdraw the request. If the City does not have a response from you within 10 business days, the City shall not fulfill the request.
Please remit to:
City Clerk, PO Box 554 Fairbury, Nebraska 68352
4841-9607-3492, v. 2 (12/2018)

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