PUBLIC RECORDS INSPECTION APPLICATION
City of Bowling Green, Kentucky
Telephone 270-393-3000 Fax 270-393-3698
Email
(KRS 61.870-61.991 & Code of Ordinances 2-19)
1)
REQUEST:
IS THE INFORMATION REQUESTED TO BE USED FOR COMMERCIAL PURPOSE?
_____ *YES _____ NO
Commercial purpose is the direct or indirect use of any part of a public record, in any form, for sale, resale, solicitation, rent,
or lease of a service or any use by which the user expects a profit either through commission, salary or fee. *Addendum Required.
Name:_________________________________________________ Telephone No.:_______________________
Address:_____________________________________________________________________________________
Request to Inspect the Following Public Records (Be Specific and Specify Format of Records):__________________
________________________________________________________________________________________________
________________________________________________________________________________________________
(If more space is needed, use back of this form or provide attachment)
Request for copies:
___ YES, I agree in advance to pay for copies of the above requested records.
___ NO
Applicant’s Signature:__________________________________________ Date: ____________________
2)
RECEIPT OF REQUEST:
This application received by the Office of: ( ) City Clerk ( ) City Attorney ( ) Building Inspection ( ) Licensing
( ) Other
DATE:____________________TIME:___________A.M./P.M.
Signature of Person Receiving Application:___________________________________________________
Request forwarded to:________________________________________________ ____________/______A.M./P.M.
Name/Department
Date/Time
3)
RESPONSE TO REQUEST:
This section to be completed by person responding to request.
( ) The public records requested are available for inspection in the Office of ____________________________ and
may be viewed or copies received on _____________________ at _________A.M./P.M.
( ) The public records requested are __ not available at this time OR __ inspection is denied for the following reason(s):
( ) Comments
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
______________________________________
______________________ ________________A.M./P.M.
Signature/Title of Approving Official
Department
Date/Time
Return completed form to Office of City Clerk within three (3) business days.
___________________________________________________
__________________________
Signature of Notifier
Date/Time Applicant Notified of Response
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