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2. First Name*
3. Last Name*
5. Address 1*
7. Address 2
9. City*
10. State*
11. Zip*
13. Email Address*
14. Phone Number (Optional)
16. Type of Records Requested:
    -- Select One --Fire ReportOil Tank Other

    I hereby apply to inspect or receive a copy of the following records:

18. Records*

    Please describe the public records you wish to receive. In order to expediate the search for the records, please include the following where applicable:

    • Date of Incident
    • Description of record requested, date, time location, etc.,
20. File Upload

    Please attach any documents related to your FOIL Request (Optional)

22. Signature of person making the request

    The Eastchester Fire District will respond to this request within five (5) working days.

24. Do you agree?*

    By clicking "I agree", you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

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