WEST Geauga Community Joint Recreation District                                                                                                                        E.A. Curtis

PO Box 384                                                                                                                                                                                       eacurtis@roadrunner.com

Chesterland, Ohio 44026

                                                                                            PUBLIC RECORDS REQUEST FORM

Date Requested:                                                                                                                                 

Request Submitted By:              Email               U.S. Mail               Fax              In Person

Name Of Requestor:                                                                                                                          

Street Address:                                                                                                                                   

City/Zip:                                                                                                                                            

Telephone:                                Fax:                               Email:                                                                                                       

Records Requested: *Provide as much specific detail as possible so Russell Township can identify the information that you are seeking. You may attach additional pages if necessary.*                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

Do you want copies of the documents?                       YES  -or-                    NO

--Do you want Electronic Copies OR Paper Copies?                                                           

--If you want Electronic Copies, in what format?                                                                   

 Signature

*For more information; consult ORC 149.43*

                                                                                            West Geauga Community Joint Recreation District