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2. Maryland Public Information Act Request Form
   In accordance with Maryland’s Public Information Act, Title 4 of the General Provisions Article of the Annotated Code of Maryland, the undersigned requests a copy of all public records containing information hereinafter described.
4. Date*
   Date
6. First Name*
7. Last Name*
9. Address 1*
11. Address 2
13. City*
14. State*
15. Zip Code*
17. Phone
18. Email*
20. List the requested public records:*
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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

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