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4. Subject:
6. Message:
8. First Name
9. Last Name
11. Address1
13. Address2
15. City
16. State
17. Zip
19. E-Mail
20. Daytime Phone Number

    Include area code

22. Disclaimer:

    Under Florida law, e-mail addresses are public records. If you do not want the contents of this form (including your e-mail address) released in response to a public records request, do not use this form. Instead, contact this office by phone or in writing. Please be advised that most records received and maintained by the City of Atlantic Beach are public records and subject to the disclosure provisions of Sec. 119.07, Florida Statutes.

23. Please do not use this form to submit a public records request; rather, click on the following link.
    Record Request
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field