Form Center

Public Records Request Form

2. Date of this request:*
   Date of this request:

4. Requestor's Name

6. Title of record requested (if known):

8. Date of record requested (if known):
   Date of record requested (if known):

9. Location of record requested (if known):

11. Complete description of the record requested:*

13. Indicate the format in which you wish to receive the requested record:

    1. I want to inspect the record (no fee).
    2. I want a digital copy of the record emailed to the address above (no fee).
    3. I want a photocopy of the records (Fee required - see Terms).
    4. I want a photocopy of the records mailed to me. (Fee required - see Terms).

15. Mailing Address (If requesting documents to be mailed)

17. City

18. State

19. Zip Code

21. Phone

22. Email (where digital records are to be emailed to)*

24. Town of Black Mountain<br> Town Clerk / <abbr>PIO</abbr><br> Public Records Request<br> 160 Midland Avenue<br> Black Mountain, NC 28711<br><br> <a class="Hyperlink" target="_self" href="mailto:Townclerk@townofblackmountain.org">Email the Town Clerk</a><br><br> Fax: 828-669-4204

    Town of Black Mountain
    Town Clerk / PIO
    Public Records Request
    160 Midland Avenue
    Black Mountain, NC 28711
    
    Email the Town Clerk
    
    Fax: 828-669-4204

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field