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2. Notice to requestors:  You are not required to provide your name, address and phone number to receive a department record, however this information is useful in getting the requested information to the correct person and clarifying any ambiguities to the request.  Records are processed Monday-Friday 8:00am-4:00pm and may take more than seven business days to process dependent on the information requested.  Description of the records requested must be specific.  Estimated costs to fulfill request will be provided if in excess of $20.00. Copy Costs: $0.30 per page 

4. Date*
   Date

   Date
6. First Name
7. Last Name
9. Address
11. City
12. State
13. Zip Code
15. Phone Number
16. Fax Number
18. Email Address
20. Description of Record(s) Requested (be specific)*
22. How would you like to receive records?*

    1. Village Hall Pick Up
    2. Mail
    3. Email
    4. Fax
24. Additional Information or Comments

26. By submitting this form I realize I will be responsible for all legally prescribed costs involved in the processing of this request pursuant to Wis. Stat. 19.35.  I further realize that if the request is denied for cause pursuant to Wis. Stat. 19.36 I have the right to have the denial reviewed by Writ of Mandamus or upon application to the Attorney General or Milwaukee County District Attorney pursuant to 19.37.

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

    This field is not part of the form submission.

30. Submit

* indicates a required field