Fillable 2017 Records Request (City of Gulfport Mississippi)

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2017 Records Request (City of Gulfport Mississippi)

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U.S.A. forms for City of Gulfport Mississippi

BROWSE CITY OF GULFPORT MISSISSIPPI (MS) FORMS

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Revised 5/2019
Mayor-Council Form of Government
City of Gulfport Public Records Request Form
Request Date: ___________________
All records requests are to be directed to:
City Clerk / Records Manager
P. O. Box 1780
Gulfport, MS 39502
Fax: (228)868-0323
Email: RecordsRequest@gulfport-ms.gov
Person/Business making request:
Address:
Telephone Number:
Email Address:
All requests must be clear and concise & shall be directed toward only one subject matter per request.
Case #/Subject Matter:
For Court/Police Records
Subject’s Date of Birth:
Subject’s SSN:
Manner of Compliance
Personally inspect only
Electronic Copies to be provided
Physical copies to be provided
Manner of Delivery
By mail to the address listed above
Email or Fax
In person at the office of the request that has been submitted
Fee Schedule
Per Page
GIS Map (11” x 17”)
$10.00
Postage (per stamp)
GIS Map (36” x 48” / 24” x 36”)
$15.00
Research, copy and/ or scan time (per hour)
Data burned onto DVD
$15.00 per DVD
Actual cost of compliance of request, if granted, shall be paid in advance of receipt of information. Please note research and production time will be based upon
the hourly rate of the lowest qualified respondent to your request. Payments can be made payable by check, money order, credit/debit cards or cash.
I have read and understand the published statements entitled Policy and Procedure “Mississippi Public Records Act of
1983” and I further understand that the actual cost of compliance with my request, if granted, shall be borne by me,
including mailing costs if applicable.
YOUR SIGNATURE IS REQUIRED, AS THIS SERVES AS YOUR ACKNOWLEDGEMENT AND AGREEMENT TO ALL OF THE
TERMS AND CONDITIONS NOTED ABOVE. YOUR REQUEST CANNOT BE PROCESSED WITHOUT A SIGNATURE.
Signature of requesting party: ____________________________
Request granted by: - City Clerk | Deputy City Clerk | Police Records Clerk
Requesting records from the following departments:
(Check all that apply.)
Information Tech / GIS
Leisure Services
Public Works
Mayor/ CAO
Purchasing
Municipal Court
Urban Development
City Clerk
City Council
Finance
Fire Department
Human Resources
Police Department
Utility Billing
Date Completed: _______________
Completed by: _________________
Receipt #: _____________________
Payment Method: ______________
Amount Paid: __________________
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2017 Records Request (City of Gulfport Mississippi)

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Completed 15 July 2020

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