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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.