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2. Important Notice
   Government Records Request Notice (OPRA) PDF

   The attached document contains important information related to your rights concerning government records. Please read it carefully.
4. Requestor Information
6. First Name*
7. Middle Initial
8. Last Name*
10. Company
12. Mailing Address*
14. City*
15. State*
16. Zip*
18. Email*
20. Business Hours Telephone*
    Please include area code and extension.
22. Preferred Delivery*

    1. On Site Inspect
    2. Pick Up
    3. US Mail
    4. Email
24. Record Request Information*
    To expedite the request, be as specific as possible in describing the records being requested.
26. Type of Access Requested*

    1. Copying
    2. Requesting
27. If Data, Medium Requested*

    1. Email
    2. Mail
    3. No Data
31. Payment Information
33. Maximum Authorization Cost
34. Select Payment Method

    1. Cash
    2. Check

    1. Money Order
36. Fees
    Paper Size 8 ½ X 11: $0.05 per page / Paper Size 8 ½ X 14: $0.07 per page
37. Delivery
    Delivery / postage fees additional depending upon delivery type.
39. Extras
    Extraordinary service fees dependent upon request.
41. Under penalty of N.J.S.A. 2C:28-3, I certify that I _______ been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States.*

    1. Have

    1. Have Not
Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

* indicates a required field