Form: VPAF-01 Page 1 of 1 Creation Date: 11/18/2019
REQUEST TO INSPECT PUBLIC RECORDS FORM
All requests will be processed in accordance with the Inspection of Public Records Act,
NMSA 1978, Chapter 14, Article 2.
Date: ________________________________
REQUESTER INFORMATION
First Name: _______________________________ Last Name: _______________________________
Address: _____________________________ City: _________________ State: _______Zip:________
Email Address: __________________________________ Telephone: _________________________
RECORDS REQUESTED
I would like to ☐ inspect ☐ receive copies of the following records:
(Please list records with reasonable particularity)
I agree to pay the applicable fees for copying and transmitting the records. If the charges will exceed
$_______, please call me to discuss. I understand that I may be asked to pay the fees in advance.
*Note: A receipt will be provided for all payments.*
FOR DEPARTMENT USE ONLY
The request to inspect public records is: 3 Day Deadline _________________________
☐ Approved 15 Day Deadline ________________________
☐ Disapproved for the following reason(s): Date Completed: _______________________
____________________________________ Cost: $ _______________________________
____________________________________ Receipt No. ____________________________
____________________________________
____________________________________
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