Mecklenburg County Public Records Request Form printable pdf download

Mecklenburg County Public Records Request Form

Mecklenburg County

Public Records Request Form

(Internal use only )

Received date: _________________________

Projected Completion Date: ______________

 fee documentation attached

Fees associated: _______________________

Date of this request: ___________________________________________

Requestor’s name: ____________________________________________________________

Street: ______________________________________________________________________

City: ___________________________________________

State: ________________________

Zip Code: ______________________

Telephone number ____________________________________________________________

Email Address ________________________________________________________________

Complete description of the record requested (attach additional pages as required):

Title of record requested (if known): ______________________________________________

Date of record requested (if known): ______________________________________________

Location of record requested (if known): ___________________________________________

Indicate the format in which you wish to receive the requested record:

 I want to inspect the record (no fee).

 I want record emailed to the address above (no fee).

 I want a photocopy of the records (Fee required - see Terms).

 I want an electronic copy of the records (Fee required - see Terms).

Mail or Deliver this completed form to:

Mecklenburg County

Public Information

3205 Freedom Drive, Suite 107

Charlotte, NC 28208

FAX: (704) 353-1440

Mecklenburg County Public Records Request Form