I hereby apply to inspect the following records:*

Your Information

Name:*

Representing

Street Number and Name:*

Address Line 2:

City:*

State:*

Zip Code:*

Phone Number:

Fax Number:

Email Address:

Preferred Contact Method:*

Do NOT contact me Email

NOTICE: YOU HAVE A RIGHT TO APPEAL A DENIAL OF THIS APPLICATION TO THE VILLAGE MANAGER USING MANAGER@SCARSDALE.COM.