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2. First Name (optional)
3. Last Name (optional)
5. Address (optional)
7. City (optional)
8. State (optional)
9. Zip (optional)
11. Requestor Contact Information is Optional

    If you have not provided a Phone Number, Mailing Address, or E-Mail with this request, the Cocoa Beach Fire Department will not be able to contact you about your request.

    Please call the Cocoa Beach Fire Department at 321 868-3330 for the status of your records request.

13. Phone Number (optional)
14. E-Mail (optional)
16. Date Range of Records Request (e.g. 11-12-13 - 07-12-14)*
18. Records Request - Please provide as much detail as possible about the record(s) being requested *
20. If requesting e-mail addresses, list names to be included
22. Provide terms to search for, to be used for e-mail and electronic records search (such as: "Name", "Topic")
24. Are you aware of any litigation related to the records request?

    1. Yes
    2. No
26. Contact Information Requirements*

    If you have not provided your Phone Number, Address, or E-Mail with this request, the Records Division has no way of contacting you.

    Please call the Fire Department at 321 868-3330 to check on the status of your records request. 

    Cocoa Beach Fire Department
    50 S. Orlando Avenue
    Cocoa Beach, Fl. 32932-2430
    E-mail:

    FDPublicRecordsRequest@cityofcocoabeach.com

    1. I read the Contact Information Requirements
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