Request for Disclosure of Information

General Office:
1931 Second St. SW
Albuquerque, NM 87102

Mailing Address:
P.O. Box 581
Albuquerque, NM 87103

Phone and Fax:
T: (505) 247-0234 // (505) 247-0235
F: (505) 243-7308

Office Hours:
Monday - Friday 8:00 a.m. - 4:30 p.m.
Closed on Holidays.

Request for Disclosure of Information
	Name of Requestor:
	Date:
	Address:
	City:
	ZIP Code:
	Telephone:
	Email:
	Received:	Written In Person Telephone Webstie
	Description of Request:
	Date Required:


For District Use Only
	Information Determined	Non-Confidential Confidential
	Date (Approved for Release)
	Chief Engineer
	Date (Not Approved for Release)
	Chief Engineer
	Date (Approved by Board of Directors)
	Chief Engineer
Written request must be forwarded to MRGCD Board of Directors and will be placed on the next regular Board Meeting Agenda for action by the Board, as per MRGCD Rule 22
	Board Director Initial Here
	Route To:	Secretary/Treasurer Staff Secretary Land/Engineering Personnel
DELIVERY OF REQUESTED INFORMATION: The Chief Engineer will make every effort to promptly comply with requests, however the Chief Engineer reserves the right to provide staff allowances for time-consuming requests
	Date of Delivery, if other than Date Required above.
	Explanation:
Charge for Copies
	Number of Pages:
	Cost per Page:
	Total Cost:
I have received all information as requested
	Signature of the Requestor:

For District Use Only