2. To Village of Riverside FOIA Officer
4. Requestor's Name
5. Phone Number
7. Address
9. City
10. State
11. Zip Code
13. Email Address
15. Place of Employment
17. Address
19. City
20. State
21. Zip Code
23. Description of Village Record(s) requested.
25. Records to be used for the following purpose(s)
27. Do you wish to inspect the record(s)?

    1. Yes
    2. No
28. Do you wish to receive copies?

    1. Yes
    2. No
29. Certified copies?

    1. Yes
    2. No
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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