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Public Information Act Request Form

2. Disclaimer
   For marriage, divorce, or death records please contact the Frederick County Courthouse at 301-600-1965.

   For marriage, divorce, or death records please contact the Frederick County Courthouse at 301-600-1965.

4. Select the department that will receive your request:*
   -- Select One --BlankAirportCode EnforcementCommunity Action AgencyEconomic DevelopmentEngineeringFinanceHuman ResourcesLegalParkingParks & RecreationPermitsPlanning Public WorksPurchasingTechnology

6. Applicant Name:*

8. Applicant Address:*

10. City:*

12. State:*

14. Zip:*

16. Home Phone:

18. Business Phone:

20. E-Mail:

22. Description of Requested Public Document:*

24. Choose the Form of Response:

    (**Copies of Documents cost $0.25 per page, unless separate Departmental fee schedule applies. Payment of postage costs are required if copies are mailed to an address.) *

    1. Copies of Document - Pickup
    2. Copies of Document - Mail to address above
    3. Inspection of Documents Only

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field