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2. Individual Name*
3. Date*
   Date
5. Business/Organization Name*
7. Mailing Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
16. Describe or identify the records that you want to inspect or copied in as much detail as possible.*
18. List all City departments that this request or any similar requests are being submitted to*
    The City of Annapolis charges a fee of 25 cents per page for copies of documents. There is no copy fee charged for requests of fewer than 10 pages. There may also be a fee of $30. per hour for retrieval and review of the records if the retrieval and review take more than 2 hours. In the case of an unusually large expense, prepayment may be required in advance.
20. Please review below*

    1. I am willing to pay all fees for this request without prior notification.
    2. I am willing to pay fees for this request up to a maximum of $
    3. If you estimate that the fees will exceed this limit, please contact me at the email address above.
    4. I am requesting that fees be waived on the following grounds:
21. maximum of $*
23. the following grounds:*
25. Have you submitted related requests to any other City Departments?*

    1. Yes
    2. No
26. If yes, please identify your request(s):*
28. A “person in interest” is a person who is the subject of the record, that person’s designee, or that person’s parent or legal representative if the person has a disability. Under law, certain records that would not otherwise be available may be available to a “person in interest.” At your option, you may indicate if you are a “person in interest.” Are you a “person in interest?” If yes, please explain below.*

    1. Yes
    2. No
29. Are you a “person in interest?” If yes, please explain below*
31. Does any part of this request relate to any City-owned building or property?

    1. Yes
    2. No
33. Owner Signature (First and Last Name)*

    By typing in my name here I confirm that I agree to be bound thereby.

34. Date*
    Date
Leave This Blank:


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

    This field is not part of the form submission.

38. Submit

* indicates a required field