Borough Hall, 19 Double Trouble Rd, South Toms River, NJ 08757
Telephone: 732.349.0403
Fax: 732.349.5266

APPLICATION FOR RECORDS REQUEST

Name:

Address:

Day Phone: Cell Phone #

E-Mail: Fax #

Record Request Information: Please be as specific as possible in describing the records being requested. Also, please note that your preferred method of delivery will only be accommodated if the custodian has the technological means and the integrity of the document will not be jeopardized. Please put your request in this box please be SPECIFIC and concise as to what DOCUMENT you want.

I WISH ACCESS TO THE FOLLOWING PUBLIC RECORDS:

COST OF COPIES: Letter $.05, Legal $.07 each page Signature of Applicant

It shall be the responsibility of the applicant to update any and all pertinent information on this application:
Date Applicant Signature