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2. Please specifically list the requested information:*
4. Name*
6. Address*
8. City*
9. State*
10. Zip Code*
12. Business Name
14. Address
16. City
17. State
18. Zip Code
20. Phone Number*
21. Fax Number
23. Email Address*
25. 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.
27. Electronic Signature*
29. The information you requested for copying or inspecting may be protected information under the Texas Public Information Act, Government Code, Chapter 552, which may require a determination by the legal departments to confidentiality prior to its release. If you wish to receive a physical copy of the information requested, you will be charged 10 cents per page. Additional charges may be incurred for non standard copies or information collected on electronic medium. The act does not require the city to create new information, compile data, do legal research, answer questions, or deliver electronic information in a particular file type. Under the Texas Public Information Act the City of Orange has 10 days to respond to requests for open records.
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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

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