Public Records Request Form - Teton County Idaho

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Public Records Request
Teton County Idaho
150 Courthouse Drive • Driggs, Idaho 83422
208-354-8780 • FAX 208-354-8410
Your request for public records pursuant to Idaho Code 9-337 through 9-350 will be processed within three working days of
the date of receipt of the request. If more time is neede4d top process your request, you will be notified in writing and your
request will be answered within 10- working days. Fees will be charged pursuant to State Code, County Resolution and
Judicial Order. Voluminous and/or complex requests will incur labor costs that must be paid in advance. All fees must be
paid in full before the records are released.
PLEASE COMPLETE THE FOLLOWING INFORMATION
Name _____________________________________________ Phone ________________________________
Business/Organization (if applicable) _________________________________________________________
Mailing Address ____________________________________________________________________________
Street/PO Box
City
State
Zip
Will the information provided be used for a mailing list or telephone list?
 Yes  No
Describe the specific records requested (County staff may help requesters narrow the scope of requests):
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Signature __________________________________________________________________________
STAFF USE ONLY
FEES CHARGED
_____________ x ________ = $ ________
Date Received ___________ By ________________
# of Pages Copied
Request Completed By _______________________
_____________ x ________ = $ ________
Requester Notified On _______________________
# of Discs/Tapes Copied
Request Picked Up On _______________________
_____________ x ________ = $ ________
Request Denied Because _____________________
# of Hours Worked
__________________________________________
_____________ x ________ = $ ________
# of Pages Copied
Prosecutor Approval or Denial ________________
TOTAL COST = $
– O V E R –
Public Records Request Form 05-2011
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