Public Records Request

REQUESTOR INFORMATION

Form Date Field*

Requestor Name:*

Organization/Company Name:*

Mailing Address:*

City:*

State:*

Zip:*

Daytime Phone:*

Email Address:*

Fax Number:*

Description of Requested Records*

Please describe the materials you are requesting in as much detail as possible: type of document, date, author, title, timeframes, places, events, subjects, file designation or descriptions. Please indicate whether you want to inspect the records or if you would prefer copies of the records.

Public records requests are considered received by RCC when read by the recipient. •Acknowledgement of receipt of the request will be made within 5 business days of receiving the request. •Costs may include staff time required for searching, retrieving, and re-filing records; reviewing records to redact exempt material (upon review by legal staff); supervising the inspection of records; copying records; and mailing costs (see Public Records Fees Worksheet). • If the estimated costs are less than $25.00, payment will be due upon receipt and will require your approval before work begins. • If the estimated costs exceed $25.00, an estimate will be provided and will require your approval before work begins. • If the estimated costs exceed $100.00, a 50% deposit may be required before work begins. • If you are requesting a waiver or fee reduction, please explain how this request is in the public interest.

I HAVE READ AND AGREE TO COMPLY WITH THE ABOVE CONDITIONS, and further agree to pay the cost of fulfilling this Public Records Request according to the conditions set forth above.*

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