Village of Hazel Crest
Request for Public Records

Name: ________________________________________________________________________

Address: ______________________________________________________________________

City:  ________________________ State: _______________      Zip Code: ______________

Telephone Number: ____________________________________________________________

Date of Request: _______________________________________________________________

Please describe here the public records you are requesting. In order to expedite the search for the records, please be as specific as possible.

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_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

The Village will respond to this request within seven (7) working days.

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Signature of person making request

(for Office Use Only)

________ Police

________ Fire/Building

________ Public Works

________ Community & Economic Development

________ Manager’s Office