Public Records Request Form

All public records requests received by the Village will be directed to:

Dwight Danie, Village Clerk/Records Custodian, or
Alex Cardelle, Deputy Village Clerk

Contact Information:

Phone: 305.866.4633
FAX: 305.993.5163
Email records@balharbourfl.gov
Address: Office of the Village Clerk, 655 96th Street, Bal Harbour, FL 33154.

Public Records Request Form

Pursuant to Section 119.07, Florida Statutes, the below identified person hereby request to

inspect the following records
receive a copy of the following records

Date of Request

Type of Records

Details

Time Period for Record(s)

REQUESTOR CONTACT INFORMATION

It is NOT required that the Village Clerk obtain the name address, telephone number, or other personal information from the person making the request, and such person may decline to provide such information. In the event that the person making the request for public records declines to provide a written request, a written request shall not be required, and instead the Village Clerk shall complete this form, in order to document the request and the Village's compliance.

Name of Requestor

Phone #

Fax #

Mailing Address