REFERENCE REQUEST - Maryland State Archives
STATE RECORDS MANAGEMENT CENTER
RECORDS REQUEST
Use a separate form for each request
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|Request Date | |
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|RECORDS REQUESTED |
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|Case Name or Title | |
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|Case Number | |Date or | |
| | |Year | |
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|Other Information | |
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|LOCATION OF RECORDS |
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|Accession or Lot No. |Box Number |Range(s) |Section(s) |
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|REQUESTOR |
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|Name | |Title | |
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|Agency | |Division | |
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|Street Address | |
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|City | |State | |Zip Code | |
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|Telephone Number | |
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|e-Mail Address | |
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|FOR RECORDS CENTER USE ONLY |
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| |Records Destroyed | |Additional Information Needed |
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| |Records Missing From Box | |
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| |Records Charged Out to: | |
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|Name Date | |
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|Searcher’s Initials |Date |
Mailing Address: Telephone Number: 410-799-1930
State Records Management Center FAX Number: 410-799-8532
P.O. Box 275
Jessup, Maryland 20794
DGS 550-8 (Rev. 3/06)
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