Fillable LS Request For Public Records Form Rev. 10.2010 ( - License Services Request for Public Records Form REV 10.20\205)

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LS Request For Public Records Form Rev. 10.2010 ( - License Services Request for Public Records Form REV 10.20\205)

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The LS Request For Public Records Form Rev. 10.2010 ( - License Services Request for Public Records Form REV 10.20\205) form is 1 page long and contains:

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  • 2 check-boxes
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File type: PDF

U.S.A. forms for City of Phoenix

BROWSE CITY OF PHOENIX (AZ) FORMS

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Rev. 10.2010
REQUEST FOR: □ Review
(Please check one) □ Copy (p
ayment for copies made on the 15th Floor – main counter)
City of Phoenix
-
C
ity Clerk Department
License Services Section
200 W. Washington, 1
st
Floor
Phoenix, AZ 85003
Request for Public Records
Under the provisions of A.R.S. 39-121, Public Records Law, a person may request to examine or be furnished
copies, printouts, or photographs of any existing public record unless the interests of privacy, confidentiality or
best interest of the state outweigh the general policy of open access.
There is no charge to review documents. A fifteen-cent fee will be charged for each page printed and a
nineteen-cent fee will be charged for each photocopy in response to a request for documents. If necessary,
reasonable efforts will be made to contact the requestor with an estimation of cost.
Every effort will be made to respond to a request for documents promptly, as required by the law. However,
the extent of the research necessary will determine the actual time required to produce copies of requested
documents.
Under the provisions of A.R.S. 39-121, Public Records Law, it is requested that the following records
be released (please be specific):
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
(If applicable) Property Address(es):
_________________________________________________
These records will be used for the following purpose(s):
__________________________________________________________________________________________
_____________________________________________________________________________
(Commercial use may result in additional fees.)
Please provide the following information:
Date Requestor’s Name (please print)
Requestor’s Signature
Address Zip Code
Telephone Number (for contact once information is ready for release)
FOR OFFICE USE
Request filled by:______________________________ Date released:___________
Brief summary of type of record released: _______________________________________________________________
________________________________________________________________________________________________
If Copies: # of pgs printed:______ Cost:_____ # of photocopies_____ Cost:_____ TOTAL COST: ______________
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LS Request For Public Records Form Rev. 10.2010 ( - License Services Request for Public Records Form REV 10.20205)

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Completed 12 July 2020

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