Public Records Request

EXHIBIT “A”

REQUEST FOR ACCESS TO PUBLIC RECORDS

City of Homewood
205-332-6108
We will let you know if this request is approved or denied. If denied we will provide the reason it was denied.
First & Last Name or Company Name*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I request to review the following public record(s) of your city:*
The reason(s) I desire to review these records is:*
E-Signature*

First NameLast Name
Today's Date*

MonthDayYear
Date
*By signing your name electronically on this form, you are agreeing that your
electronic signature is the legal equivalent of your manual signature.
Should be Empty: