2. Personal Information
   You do not have to provide any of the below contact information. However, if you want us to respond, we will need some type of contact information. In addition, if we do not understand your request and need to get clarification from you, without contact information we will not be able to begin processing your request until you contact us.
4. First Name
5. Last Name
7. Mailing Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Email Address
18. Information Request
20. Date of Request:*
    Date of Request:
22. I am requesting data in the following way:*
    -- Select One --InspectionCopiesBoth Inspection and Copies

    Note: Inspection is free, but copies are charged for as outlined in Copy Costs on Page 7 of the Minnesota Data Practices Manual for Itasca County.
23. Applicable County Office:*
    -- Select One --Administrative Services Department/County BoardAssessor's DepartmentAttorney's OfficeAuditor/Treasurer's OfficeDepartment of Surveying & MappingEnvironmental Services DepartmentHealth & Human Services DepartmentHuman Resources DepartmentLand DepartmentRecorder's OfficeSheriff's OfficeTransportation DepartmentVeterans Services DepartmentOther

    Please select the county department that you believe is most applicable to your request. If you don't know, please select "other".

25. Description of Data Requested:
    Please describe the data you are requesting as specifically as possible.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

* indicates a required field