Records Management Officer

2. 
3. Town of Victor

   85 East Main Street
   Victor NY 14564
   585-742-5080

4. Date:*
   Date:
6. First Name*
7. Last Name*
9. Mailing Address*
11. Address 2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Email Address*
20. Representing (if applicable)
22. I hereby apply to:

    1. Inspect

    1. Obtain Copies:

            of the following record(s):

24. If request pertains to property, please complete the following:

    1. Residential
    2. Commercial
25. Address of Request:
27. Records Requested:*

    Please describe the public records you wish to recieve. In order to expediate the search for the records, please be as specific as possible.

29. Department*

    1. Assessment
    2. Planning & Building
    3. Town Clerk

    1. Historian
    2. Economic Development

    1. Finance
    2. Parks & Recreation

    1. Highway
    2. Other
31. Signature of person making the request

    Within five (5) business days of the request: the record(s) will be available; OR written acknowledgement of the request and a statement of the approximate date the requested information will be available or denied; OR an explanation of denial in writing.

33. Records may be emailed upon request. If the requested records cannot be emailed, notification will be sent as to the options available for obtaining the records.

    There is a $.25 copying charge for standard copies made. Additional charges apply for large documents (actual cost of reproduction), tapes, CDs, or photographs.

    Records may be inspected, picked up in person, or mailed to applicant. If mailed, postage will be charged.

35. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
37. Electronic Signature*
38. Reply Email*
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field