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Confidentiality Statement - Boards & Commissions

  1. To: Cedar Hill City Secretary

  2. Please put board name here.

  3. From this date forward, I hereby request that public access to personal information in the custody of the City of Cedar Hill, Texas that relates to my:

  4. Please list the numbers and addresses.

  5. Home Address:*

  6. Home Telephone Number:*

  7. Business Telephone Number:*

  8. Cell Phone Number:*

  9. Email Address:*

  10. Information that reveals whether I have family members:

  11. (Please check the appropriate response for each item listed above)

  12. Leave This Blank:

  13. This field is not part of the form submission.