APPENDIX A: PUBLIC RECORDS REQUEST FORM.

   Request For Records Pursuant To Indiana Access To Public Records Act

   (I.C. 5-14-3-1, et seq., as amended)

I,                                                                                           , hereby request of the Town of

Plainfield, Indiana, the right to inspect and copy the following records:

Dated this             day of                                                                      , 20     .

The Town may provide me with its response to this request:

[ ]   By email at                                                                                    .

[ ]   By telephone at                                                                                   .

[ ]   By mail at                                                                                           .

[ ]   Other                                                                                                 .

Received by:                        at                            .m. on                                    , 20       .

Signature:                                                                                                                                

Printed Name and Town Department:                                                                                          

Sent to Legal Department for response on:                                            by                                    

Received by Legal Department on                                 by                                                          

(Ord. 3-2019, passed 1-28-2019)