10/30/2018
PLANNING AND DEVELOPMENT SERVICES
DEPARTMENT (PDSD)
201 N STONE AVE, 85701
P. O. Box 27210
Tucson, AZ 85726-7210
PHONE: (520) 837-5013
neighborhood@tucsonaz.gov
OFFICER’S INFORMATION RELEASE FORM
In accordance with the provisions of Arizona Revised Statute § 39-121, the following
information will become part of the public record, and we are required to release it to
anyone who requests it. With that in mind, you may wish to designate one mailing
address for your association or have a post office box address to protect the privacy
of individuals’ home addresses, telephone numbers and email address.
Information posted on the Neighborhood Resources website: Name, Phone
and Email.
Please Print
ASSOCIATION: ______________________DATE: _____________WARD: ______
OFFICE HELD ______________________________________________________
NAME: ____________________________________________________________
Home Phone: ____________________ Day Phone_______________________
ADDRESS:_________________________________________________________
ZIP: ______________
E-MAIL: ________________________________________
To receive neighborhood leadership mailings electronically, sign up at https://www.tucsonaz.gov/integrated-
planning/neighborhood-association-listserv
I subscribe to the Neighborhood Association listserv.
SIGNATURE: _____________________________________________
(electronic signature acceptable)
click to sign
signature
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