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Request for Public Records

2. City of Belvedere Request for Public Records
   List the requested records. Please be as specific as possible. City staff will make the records available in the manner prescribed by California Government Code Sections 6253, 6253.1, and 81008.

   List the requested records. Please be as specific as possible. City staff will make the records available in the manner prescribed by California Government Code Sections 6253, 6253.1, and 81008.

4. Name:*

6. Mailing Address:*

8. City:*

9. State:*

10. Zip Code:*

12. Phone Number:*

13. Email Address:*

15. Preferred method of notification when records are ready:

    1. Phone
    2. Email

17. Records Requested:*

    Please include dates, times, locations, and other information which will help staff expedite your request.

19. Date range of records requested:

20. Address associated with record:

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field