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This form is intended to be used to obtain general information.  Please do not provide sensitive information such as your Social Security Number, bank account or credit card number, or information that would enable someone to access an online account such as your username and password.  Information about how EMWD will use your information can be found at http://www.emwd.org/home/showdocument?id=2165.

By completing and submitting this form, I respectfully request certain public records pursuant to the California Public Records Act (Section 6250 and following of the Government Code):

Record(s) Requested:

Title/Document Number/Description Date/Period Pages Total Copies
Request #1
Request #2
Request #3
Request #4
Request #5
I understand that there may be a charge for reproduction of all materials that I request and I agree to pay for all direct costs of duplicating materials received. (Refer to Form S.F. EN-19 for print charges, which may be revised periodically to cover the direct costs of duplication).
Please complete the following:
I understand that there may be a charge for reproduction of all materials that I request and I agree to pay for all direct costs of duplicating materials received. (Refer to Form S.F. EN-19 for print charges, which may be revised periodically to cover the direct costs of duplication). Please complete the following:

Optional:

Preferred Contact Method

Preferred Contact Method
NOTE: Legal records may be subject to Attorney-Client Privilege and any other applicable provisions of law. The District reserves the right to omit any portion of the material requested that is exempt by applicable provisions of law, but shall provide the remainder of the information as requested.
TOTAL AMOUNT DUE:
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