Public Records Request Form

The Tennessee Public Records Act (TPRA) grants Tennessee citizens the right to access open public records that exist at the time of the request. The TPRA does not require records custodians to compile information or create records that do not exist. City of Dickson Attn: Taylor Weiss 600 East Walnut Street Dickson, TN 37055 Tel: (615) 441-9508 email: records@cityofdickson.com

Name

Address

CityStateZip

Telephone

Format: (000) 000-0000.

Email

example@example.com

Type of Request:

Do you wish to waive your right to an estimate and agree to pay copying and duplication costs in an amount not to exceed :Place amount below

If you agree to waive your right to receive an estimate, initial here

Delivery preference

Other

Is the requestor a Tennessee Citizen

If yes, upload a picture of your Tennessee driver's license or government-issued Photo Identification.

Upload Tennessee ID

Record(s) Requested: Provide a detailed description of the record(s) requested, including: (1) type of record; (2) timeframe or dates for the record(s) sought; and (3) subject matter or key words related to the record(s Under the TPRA, record requests must be sufficiently detailed to enable a governmental entity to identify the specific records sought. As such, your request must provide enough detail to enable the records custodian responding to the request to identify the specific records you are seeking.

Provide a detailed description of the records requested including 1 type of record 2 timeframe or dates for the records sought and 3 subject matter or key words related to the records Under the TPRA record requests must be sufficiently detailed to enable a governmental entity to identify the specific records sought As such your request must provide enough detail to enable the records custodian responding to the request to identify the specific records you are seeking

Signature of Requestor and Date Submitted

Signature of Requestor and Date Submitted By signing, requestor acknowledges he/she has read and understands the City of Dickson's Public Records Policy and will abide by all requirements, including all payments of costs, labor and postage in fulfilling this request.

PUBLIC RECORDS REQUEST FORM