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2. First Name
3. Last Name
5. Address 1
7. Address 2
9. City
10. State
11. Zip
13. Phone Number*
14. Email Address*
16. Requested Records*

    Please provide a clear and specific description of the record(s) you are requesting.  If Record(s) is Police related, utilize the Germantown Police Department's "Request For Public Record Inspection or Copy Form" and submit to the Police Department's Office. 

18. Department(s) Involved*

    1. Community Development
    2. Building Inspection/Permits
    3. Public Works
    4. Engineering
    5. Clerk (Elections/Licensing)

    1. Administration
    2. Finance
    3. Park and Recreation
    4. Other
20. Requested Record Format*

    1. Physical Printed Copy
    2. Electronic Copy
21. When Records Are Ready:*

    1. Requestor Will Pick Up
    2. Mail Records
    3. Email Records
23. Do you agree?*

    By clicking "I agree" you agree and acknowledge that you read and acknowledge the below statements relating to records request costs

    1. I Agree

25. The Requester of the record is responsible for the actual, reasonable and necessary costs to locate, reproduce and send the records in compliance with the request. Pursuant to WI Stats 19.35(3)(a), an authority may impose a fee upon the Requester of a copy of a record which may not exceed the actual, necessary and direct cost of reproduction and transcription of the record, unless a fee is otherwise specifically established or authorized to be established by law. Additionally, an authority is not required to create a new record by extracting information from existing records and compiling the information in a new format.

    Under Wis. Stat. § 19.35(3)(c), the Village “may impose a fee upon a requester for locating a record, not exceeding the actual, necessary and direct cost of location, if the cost is $50 or more.” Furthermore, the Village “may require prepayment by a requester of any fee or fees imposed under this subsection if the total amount exceeds $5.” Wis. Stat. § 19.35(3)(f).

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

    This field is not part of the form submission.

29. Submit

* indicates a required field