PIA Request Form - City of Salisbury MD

Name*
First Last
Home Phone*
Business Phone
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Description of Public Document*
Method of Delivery*
- Pickup
- Mail
Pick up (You will be notified by telephone or E-Mail when documents are available.) Mail to address indicated above (Requires prepayment of postage costs.)
Form of Response*
- Inspection of Documents Only
- Copy of Documents
Inspection of documents only Copies of documents (Requires prepayment of copying costs - $.25 per page, unless separate departmental fee schedule applies. No fee will be assessed if totaling $1.00 or less.)
The City of Salisbury will produce the requested documents within thirty (30) days if the documents are available. If your request is denied, you will be notified within ten (10) days. If the request requires more than two (2) hours to research and compile, you may be charged for the employee's time after the first two hours. You will be notified of the estimated cost and, if the scope of work is extensive, a deposit may be required.
Electronic Signature*

Please type in your name acting as your digital signature.