2. First Name*
3. Last Name*
5. Mailing Address*
7. City*
8. State*
9. Zip*
11. Phone Number*
12. Email Address*
14. Records*
    RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, supply date, file title, tax map number and any other pertinent information).
16. Department*

    1. Administration
    2. Accounting
    3. Assessors
    4. Building
    5. Clerk

    1. Community Development
    2. Highway
    3. Public Works
    4. Tax Receiver
    5. Other
18. Signature (enter your name) of person making the request*
    The Town will respond to this request within five (5) working days.
20. Do you agree?*

    By clicking ?I agree,? you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your ?electronic signature? is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit Submit and Print

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