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2. Last Name*
3. First Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Email Address*
12. Phone Number*
14. Date of Submission*
    Date of Submission
16. Information Request*
    Be as specific as possible. Failure to provide specific information will result in the delay of fulfilling your request. Please provide all information you have concerning your request. Public information refers to information collected, assembled, produced or maintained in the course of transacting public business. Your request should be for documents or other information that is already in existence. Governmental bodies are NOT required to answer questions, perform legal research, or comply with a continuing request to supply information on a periodic basis as such information is prepared in the future.
18. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
20. Electronic Signature*
22. Forms will be electronically submitted to the City Secretary's Office. If you have any questions, please call (210) 619-1030.
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24. 1. Receive an email copy of this form.
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