OPRA Request Form

OPRA REQUEST FORM

Requester Name:    Mailing Address:

Telephone:    Email:    Date of Request:

Records Custodian / Agency Name:    Agency Address:

Recitals

WHEREAS, the Requester is a person seeking access to public records maintained by the Records Custodian identified above pursuant to the applicable public records law that guarantees public access to government records; and

WHEREAS, the Records Custodian has the authority and obligation to locate, retrieve, and produce public records in the possession of the Agency, subject to statutory exemptions and permitted redactions; and

WHEREAS, the parties desire to set forth the Requester's official request and the Agency's procedures for processing, responding to, and delivering responsive records under the terms set forth below.

NOW, THEREFORE

In consideration of the mutual covenants contained herein, the Requester hereby submits the following formal request to the Records Custodian and the Records Custodian agrees to process the request in accordance with the terms below.

1. REQUEST FOR RECORDS

The Requester seeks production of identifiable public records described with sufficient specificity to enable the Records Custodian to locate them. Provide a detailed description of the requested records, including document types, subject matter, and any file or reference numbers:

If applicable, specify the date range for the records requested: From through .

2. FORMAT AND DELIVERY

Preferred format for production (check all that apply):

Paper copies    Electronic copies (PDF or native files)    Inspect records on-site

3. FEES AND PAYMENT

The Requester acknowledges that fees may be charged for duplication, search, and review, consistent with applicable law. The Requester indicates the following:

I request a fee waiver on the grounds that disclosure is in the public interest and not primarily for commercial purpose.    I agree to pay fees not to exceed $

If the estimated fees exceed the amount above, please contact me at the telephone number or email provided prior to incurring additional costs:

4. EXEMPTIONS, REDACTION AND LIMITATIONS

The Records Custodian may redact records or withhold records that are exempt from disclosure under applicable law. If a record or portion of a record is withheld, the Records Custodian will provide a written statement specifying the statutory basis for withholding and, to the extent feasible, a description of the withheld material.

5. RESPONSE TIME AND EXTENSIONS

The Records Custodian will respond to this request within the time required by the controlling public records law. If additional time is required to locate or retrieve large volumes of records, the Records Custodian will notify the Requester in writing of any reasonable extension and the reasons for the extension.

6. CERTIFICATION

The Requester certifies under penalty of perjury that the information provided herein is true and correct to the best of the Requester's knowledge. If a fee waiver is requested, the Requester further certifies that the reason for the waiver is accurate and that the purpose of the request is not primarily for commercial gain unless otherwise disclosed.

Is this request being made for a commercial purpose?    Yes    No

7. NOTICES

All notices, requests for clarification, or fee estimates from the Records Custodian will be sent to the Requester at the mailing address or email address provided above unless the Requester designates an alternate contact below:

8. MISCELLANEOUS PROVISIONS

Governing Law: This Request shall be governed by and construed in accordance with the laws that govern public access to government records in the jurisdiction of the Records Custodian.

Entire Agreement: This form constitutes the entire written request and supersedes any prior written request submitted by the Requester for the same records, unless otherwise noted in writing.

Severability: If any provision of this Request is held invalid or unenforceable, the remainder of the Request shall remain in full force and effect.

Amendments and Waiver: Any amendment or waiver of the terms of this Request must be in writing signed by both the Requester and an authorized representative of the Records Custodian. Failure to enforce any provision shall not constitute a waiver of that provision.

Counterparts: This Request may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

9. ACKNOWLEDGMENT

By signing below, the Requester certifies the accuracy of the information provided and acknowledges that the Records Custodian may contact the Requester for clarification or fee authorization. The Records Custodian acknowledges receipt of this Request and commits to process it consistent with applicable law and agency procedures.

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