Date of Request
Requester Contact Information
City, State, Zip:
Check one: Paper copies Electronic copies Certified copies Inspection (in person)
Please be specific and include as much detail as possible regarding the records you are requesting.
To complete an estimate, the agency will need the following information:
I will pick up Please FedEx
Fed Ex billing number:
Please send USPS E-mail (if format allows)
I understand there may be a charge for copies of public records. I understand I will receive a written estimate for production of the
records indicated above if the estimated cost is expected to be over $25.00, which I will be required to pay in full prior to inspection or
reproduction. Materials will be held for 30 days.
Office Use Only
Attorney General’s Office notified
Receipt acknowledgement issued
Director’s Office notified
Request denied in whole
Retain request form for 90 days following completing of request.
STATE OF NEVADA
Public Records Request
Deliver, Mail, or Fax to:
555 Wright Way, Carson City, NV 89711
Fax: (775) 684-4809
Attention: Public Records Officer