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Electronic Request Form

Please review the list of required information provided in the previous page to determine what information you must provide to the Department in order to fill your request and, if necessary, what information must be provided by fax or mail.  Failure to follow up your e-mail request with required information by fax or mail will delay the processing of your request.

Fill in the following information.  Fields with * are required.  If you would like to receive an electronic acknowledgment of your request or wish to receive your FOIL response via e-mail, please provide your e-mail address.

* Indicates required fields

Phone:
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