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Request for Public Records

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Complete this form to request public records from the City of Rensselaer.  Note that copying fees may apply.
NOTE: If you are requesting any type of Criminal Record, Marriage License or any type of Court Information you may contact the Jasper County Clerk's Office at 219-866-4926. You may visit their website at If you are attempting to obtain a birth certificate please contact the Jasper County Health Department at 219-866-4917 or visit their website at

* Denotes a required field

Please enter your contact information below. Your request cannot be completed unless each form is complete.

ZIP Code*
Second portion of ZIP Code is optional.
Telephone, Facsimile, etc.*
-- ext


Is this request to view a record or for a copy of a record?*
Please describe record request in sufficient detail to allow the city to easy identify the record sought.
*May be a fee for public records