2. 
3. ST. BERNARD PARISH GOVERNMENT - PUBLIC RECORDS REQUEST FORM
5. REQUESTOR INFORMATION
   PLEASE NOTE: Parish Government does not maintain documents such as marriage certificates, divorce certificates, criminal certificates(Clerk of Court), or police reports(Sheriff's Office).
7. First Name*
8. Last Name*
9. Current Date*
   Current Date
10. DOB*
    DOB
12. Phone Number*
13. Email Address*
15. MAILING ADDRESS
17. Street*
18. City/State*
19. Zip Code*
23. REQUEST FOR RECIEVING AND/OR VIEWING PUBLIC RECORDS
25. Records Requested:*
27. I agree to pay up to this amount for the information requested.($)*
28. How do you preffer to recieve the documents?*

    1. Email
    2. Pick-Up
    3. Postal Service (Additional Charges Apply)
30. NOTE: The cost for copies of records is $0.25 per electronic page or $0.50 per black and white copy.
    $45 per hour for electronic searches plus the cost of the copies. (Additional cost may apply.)
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

* indicates a required field