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Orbeon Demo: Public Records Act Request Form

This is an example based on the State of California Public Records Act Request Form. It shows the use of:

merged section templates
the Handwritten Signature form control
repeated grid with a maximum number of repetitions
a PDF template, with custom PDF template field names

Lease

Renew lease?

Name

Date

Company

Email

Mailing street address

Street address line 2

Phone number

Preferred method of contact in the event of questions

City

State, territory, or military post

Fax number

Zip code

Requested records

Requested record

1

Requested record

2

Requested record

Time period covering documents requested

I wish to inspect the requested records, where applicable, and do not want copies produced at this time.I would like copies of the requested records and I understand that I will be contacted with a count of the number of pages to be copied and their cost prior to copying. I understand and agree that I will be required to make payment for the copying costs prior to the documents requested being copied.

Signature of requester

e7fb0c80221b191bf18e95e08d55ef9242ddcf73

Confirm

Form Submitted

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Confirmation

Confirmation

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