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2. 
4. Trustees Office - Town of Southampton

   Application for Public Access to Records pertaining to the Trustees Office ONLY

6. Name of Requester*
8. Name of Requester Business
10. Address of Requester*
12. Telephone Number of Requester*
14. Email Address of Requester*
16. Name of Client Represented
18. I hereby request (Check One Only)*

    1. To inspect the records described below
    2. Request copies of records described below, and agree to pay all applicable fees for those copies.
    3. Request scans via email of those records described below
20. Date Range of Requested Item:
22. Resolution/Decision Numbers (boards)
24. Check Property Information

    https://gis.southamptontownny.gov/parcelsearch/

26. Address/tax map number (Parcel-specific records)
28. Any other info that will help locate the records
30. By Checking this box*

    1. I agree

    I hereby state that any property owners’ names and mailing addresses requested by me and/or disclosed by the Trustees in regards to the aforementioned FOIL request, will not be used for solicitation or fund-raising purposes. Furthermore, I will not make available the names and addresses to any other person, organization, or entity for the purpose of engaging in solicitation or fund-raising. Furthermore, I agree that the record(s) requested shall not be utilized in any manner tending to constitute an unwarranted invasion of personal privacy. I further agree to indemnify and hold the Trustees, and Town of Southampton harmless from damages and/or any claim arising from any such unauthorized use of the record(s) requested

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

    This field is not part of the form submission.

34. Submit

* indicates a required field