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City, State, Zip Code:
Please email me the following records (if possible):
Please include as much detail about the record as possible, such as relevant dates, names, descriptions, etc.
Please inform me of the cost of providing paper copies of the following records:
If all the requested records cannot be emailed to me, please inform me by email of the portions that can be emailed and advise me of the cost for reproducing the remainder of the records requested (For example: $0.25 per page or actual cost of reproduction).
If the requested records cannot be emailed to me due to the volume of the records identified in response to my request, please advise me of the actual cost of copying all records onto a CD or floppy disk