Fillable 15 046 Public Records Request (Arizona Department of Transportation)

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15 046 Public Records Request (Arizona Department of Transportation)

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The 15 046 Public Records Request (Arizona Department of Transportation) form is 1 page long and contains:

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  • 0 check-boxes
  • 17 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Arizona Department of Transportation

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About this form:
• Use this form to auto-submit a public request under Arizona
Revised Statutes § 39-121 et seq
• You may also email your request to:
ADOTPublicRecords@azdot.gov
• Review Instructions and FAQ
Fees:
• See Fee Schedule
How to complete this form:
• Form must be legible or computer generated for accuracy
Please specifically identify records by name, date of record or
incident and location
• Commercial requests must complete Request form and
Commercial Purpose Worksheet
1. COMMERCIAL Purpose Worksheet
2. MEDIA Request: Submit to: News@azdot.gov
3. RECORD Information
Name of record
Date of record/loss
Location
Route
Milepost(s)
Timeframe of search
(Dates to-from)
DESCRIPTION OF REQUEST
(Be specific. Request for “any and all records” may cause uncertainty, processing delay or the production of voluminous records.) – ADD ATTACHMENT, IF NECESSARY
(If request requires additional room, please email full request to: ADOTPublicRecords@azdot.gov)
4.Contact Information
First Name
Company
Address
(include street or box number)
City
State
Zip Code
Area Code & Telephone Number
Email Address
5. Signature
STATEMENT: I understand that copying and postage fees may be associated with my request for public records.
Signature
Date
Name
15-046 R08/19
PUBLIC RECORDS REQUEST
PLEASE COMPLETE IN FULL
Office of Safety and Risk Management
1324 N 22
nd
Avenue, Phoenix AZ 85009
(602) 712-7327; Fax: (602) 712-6545
Office Hours: 8 a.m. to 5 p.m. Except state holidays
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15 046 Public Records Request (Arizona Department of Transportation)

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Completed 12 August 2020

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