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Today's Date

Today's Date

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Contact Information of Requestor

Contact Information of Requestor

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First Name

First Name

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Last Name

Last Name

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Street Address Line 1

Street Address Line 1

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Street Address Line 2

Street Address Line 2

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City

City

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State

State

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State

State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Zip

Zip

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Phone Number

Phone Number

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Fax Number

Fax Number

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Email Address

Email Address

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Company Name

Company Name

Record Description

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Title (if known)

Title (if known)

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Date (if known)

Date (if known)

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Location (if known)

Location (if known)

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Description of Record

Please be as specific as possible. Any additional information, such as dates, locations, buildings, premises, topics, departments, associated people etc. will help us locate your requested record.

Description of Record Please be as specific as possible. Any additional information, such as dates, locations, buildings, premises, topics, departments, associated people etc. will help us locate your requested record.

Fees List

Personal copies may be made in the CaPA Office at a cost of $0.18 per page (black & white) and $0.24 per page (color). Additional charges may be assessed pursuant to N.C. Public Records Law.

Some departments may charge fees associated with staff time required for researching public records depending on the scope and type of request. That information will be provided before the request is completed.

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2. Email Address

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