Request for Public Records
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Complete this form to request public records from the City of Rensselaer.  Note that copying fees may apply.
 
NOTE: If you are requesting any type of Criminal Record, Marriage License or any type of Court Information you may contact the Jasper County Clerk's Office at 219-866-4926. You may visit their website at www.jaspercountyin.gov. If you are attempting to obtain a birth certificate please contact the Jasper County Health Department at 219-866-4917 or visit their website at http://www.jaspercountyin.gov
 
* Denotes Required Information

 
 Please enter your contact information below. Your request cannot be completed unless each form is complete.
Date  * 
,
Full Name  * 
Address  * 
City  * 
State  * 
ZIP Code  *  -
Telephone, Facsimile, etc.  *  - - ext.
Email    
 Request
Is this request to view a record or for a copy of a record?  *  To View    For a Copy   
Please describe record request in sufficient detail to allow the city to easy identify the record sought.
*May be a fee for public records
Public Record Request  * 
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