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2. Department*
   -- Select One --AdministrationCounty ClerkHealthwestHuman ResourcesInformation TechnologyProsecutor's OfficePublic DefenderPublic HealthPublic WorksSheriff's OfficeTreasurer's OfficeWastewaterOther

   Select the department you wish to send your FOIA request to:

3. If you are unable to complete the online application, please mail your FOIA request to:

   Muskegon County Administration Office Attn: FOIA Coordinator 1903 Marquette Avenue, Suite 111A, Muskegon, MI 49442 

5. Company Name (If applicable)
7. First Name*
8. Last Name*
10. Phone Number*
12. Email Address*
14. Address*
16. City*
17. State*
18. Zip Code*
20. Request for:

    1. Copy
    2. Certified Copy
    3. Record Inspection
    4. Subscription to record issued on regular basis
22. Delivery Method:*

    1. Email to address above
    2. Will pick up
    3. Will make own copies
    4. Mail to address above
24. Describe the public record(s) as specifically as possible.*
26. Electronic Consent to Non-Statutory Extension of County's Response Time

    By checking the "I agree" box below, you agree and acknowledge that you have requested a copy of records or a subscription to records or the opportunity to inspect records, pursuant to the Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq. I understand the County must respond to this request within five (5) business days after receiving it, and that the response may include taking a 10-business day extension. However, I hereby agree and stipulate to extend the County's response time for this request.

    1. I agree.
28. Electronic Signature
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

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