AAIWG PIA Request Form

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Email *

This request is for: *

Information maintained by the Active Assailant Interdisciplinary Work Group

Other information that is in the custody or control of the Active Assailant Interdisciplinary Work Group

Applicant Information

This information is used to communicate with you regarding your request.

First Name *

First, Middle Initial only

Last Name *

Last Name only

Mailing Address *

Mailing Address (Street) e.g. 123 Main Street

City *

Mailing Address (City)

State *

Mailing Address (State)

Zip Code *

Mailing Address (Zip Code)

Phone Number *

Pattern: ###-###-####

Request Description

Details of Request *

Please specify what records or information you are requesting. Provide as much detail as possible to assist with processing your request:

A copy of your responses will be emailed to the address you provided.

Submit

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