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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?

NameMissing or incorrect value

Date Missing or incorrect value

Company

Email

Mailing street addressMissing or incorrect value

Street address line 2

Phone number

Preferred method of contact in the event of questionsMissing or incorrect value

CityMissing or incorrect value

State, territory, or military post Missing or incorrect value

Fax number

Zip codeMissing or incorrect value

Requested records

Requested record

1

Requested recordMissing or incorrect value

Time period covering documents requestedMissing or incorrect value

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

eb59f38f3276fac83f1d571a91a0bec1f589b183

Confirm

Form Submitted

Review Form Validation Messages

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Unable to complete action

Confirmation

Confirmation

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