Public Information Requests – Southeast Louisiana Flood Protection Authority-West

Note: identify the documents as specifically as possible and include a date range for each request.I request that a copy of the following document(s) be provided to me:

RequestI request that a copy of the following document(s) be provided to me:

Checkbox *Please confirm Fee ScheduleDuplication Fees (Check or money order only. DO NOT send payment with this form. SLFPA-W will evaluate your request and contact you concerning fees.): • $0.25 per page • $10.00 surcharge for every 100 pages copied • $1.00 per page sent via facsimile (only for requests of 20 pages or less) • $5.00 per tape for transcription recordings • $10.00 per CD copied • $5.00 per certification

First Name *

Last Name

Company Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone *

Email Address *

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