Public Information Request Form
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This document is the Town of Centreville’s Maryland Public Information Act Request for Information form, with fields for the requester’s name, address, phone numbers, email, date requested, items requested, and signature(s) including the date the request was received. It also includes a Cost Recovery Schedule: paper copies are $0.20 per copy (two-sided pages counted as two), electronic file duplication is charged at the actual cost of the media plus preparation time if over two hours, and search/preparation time is prorated from staff and attorney salaries with the first two hours free; the requester acknowledges that the Town may withhold certain items under state law and agrees to reimburse the Town for costs.
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THE TOWN OF CENTREVILLE 101 LAWYERS ROW CENTREVILLE, MD 21617 410-758-1180 FAX 410-758-4741 WWW.TOWNOFCENTREVILLE.ORG TOWN OF CENTREVILLE Maryland Public Information Act Request for Information Name: Address: Primary Phone Number: Cell: Email Address: Date Requested: Indicate Items Requested: Per State Law, I understand that the Town may identify certain items not to provide relating to this request, and I agree to reimburse the Town of the cost of providing the requested information. Applicant’s Signature: Date Information Request Received: Applicant’s Signature: TOWN OF CENTREVILLE Maryland Public Information Act Cost Recovery Schedule Copying costs $0.20/copy (2 sided pages are considered 2 copies) plus preparation time as below if over two (2) hours Duplication of electronic files Actual cost of disk or flash drive plus preparation time as specified below if over two (2) hours Search and Preparation The cost for the search and preparation of documents for inspection and copying are calculated by prorating the salaries of the staff and attorney involved in the response by the actual time spent searching for and preparing the record for disclosure. The first two (2) hours of search and preparation are at no cost.